Many mothers have asked, “Do I have a low breast milk supply?”. Usually, all mothers have the optimal amount of milk for their babies, but there are situations where mothers may have a lower milk production, which can interfere with the baby’s growth. Low milk supply exists, and some mothers are unable to maintain exclusive breastfeeding. Many women desperately seek the cause of their low milk production and do not always find answers.

To understand hypogalactia (low milk production), you should know first that it is multifactorial; that is to say, it can be caused by various factors, and it is often difficult to determine the exact cause as it may be related to the mother, the baby or the breastfeeding technique.

Today, we will talk about the most common causes related to the mother:

Breast hypoplasia (mammary hypoplasia or insufficient glandular tissue – IGT)

Hypoplastic breasts have little or no breast tissue. It is not a matter of having small breasts; small breasts contain little fat cells, and hypoplastic breasts have little glandular tissue. To recognize this, observe the breasts carefully. These breasts have a very characteristic shape; sometimes the areolas protrude from the breast, or the breasts are shaped like a tube, or they are far apart from each other. All this may be an indication of breasts that have little breast tissue inside and, therefore, may have low milk production. You should seek help to check if your breasts are hypoplastic, and you can try, if you wish, to maintain mixed feeding (combining breastfeeding with formula milk).

PCOS

Polycystic ovarian syndrome can cause excess breast milk production but can also cause hypogalactia. Mothers with polycystic ovaries who have had difficulties getting pregnant may also have problems establishing a good amount of breast milk for their babies. Your healthcare professional may prescribe a specific medication that mothers with PCOS can safely take during pregnancy and early breastfeeding that seems to help normalize their milk production.

Sheehan’s syndrome

If severe bleeding occurs in the postpartum period—or earlier—it can compromise the functioning of the pituitary gland, which is the brain’s control center for breastfeeding. Milk production may be insufficient or even non-existent if the pituitary gland becomes necrotic due to a lack of blood supply.

Thyroid disorders

Mothers who suffer from thyroid problems during pregnancy or before pregnancy should check just after giving birth whether their thyroid hormone levels are in the normal range. The medication needed to control both hypothyroidism and hyperthyroidism is compatible with breastfeeding, and it is not necessary to stop breastfeeding for treatment.

Sustained amenorrhea (absence of menstruation) during adolescence and youth

During each menstruation, our breast develops, grow, and expand. However, women who have suffered a recurrent lack of periods in adolescence may have little breast tissue and suffer from hypogalactia when trying to breastfeed.

Retention of the placenta

Milk production begins the moment the placenta separates from the uterus. If any of it remains in the uterus, this can inhibit breastmilk production. The mother produces colostrum, but it appears that the milk doesn’t come in after 5-7 days postpartum. In this case, an ultrasound scan will detect the retention, and any remnants need to be removed.

Obesity and severe obesity

Women with a body mass index greater than 30 can suffer a delay in mature breast milk after the colostrum time. This hypogalactia can be temporary, and the baby needs to be observed during the first days to see the weight evolution. The baby should be supplemented with breastmilk or formula if necessary, and you need to wait for the coming in of the mature breast milk, which can be delayed in this case and be far later than the usual 24-48 hours.

Breast reduction surgery

When a woman has breast reduction surgery during her youth, she is usually not fully aware of the implications of this procedure. Many surgeons assure women that they will be able to breastfeed. Still, experience tells us that, at least in their first breastfeeding experiences, the milk production achieved is often not enough to maintain exclusive breastfeeding.

Other causes

Low breast milk production can be completely unrelated to a mother’s body anatomy. Instead, it can be caused by limiting feeding sessions in time and frequency and breastfeeding on a predefined schedule (which is never recommended as breastfeeding is on demand). A baby’s tongue-tie or poor suckling motions can also affect it, leading to extremely long or ineffective feeds, poor milk transfer, and little weight gain.

Breastfeeding is delicate; any imbalance or irregularity that occurs or has occurred in the mother’s body can cause a low milk supply. If a mother feels that she is producing too little milk, she should contact a breastfeeding support group a midwife or seek an IBCLC-qualified lactation consultant as soon as possible. Together, they can first check whether there really is a low milk supply and, if necessary, find the best solution.

Low milk production does not necessarily mean the end of the breastfeeding relationship. Even if not enough milk is produced, the milk that is produced is certainly of the best quality.

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