Many mothers ask: do I have 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 low milk production, which can interfere with the baby’s growth. Low milk supply exists, and there are mothers who are unable to maintain exclusive breastfeeding. Many women desperately seek the cause of their low milk production and do not always find the 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 are going to 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 breast 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 a low production. You should seek help to check if your breasts are hypoplastic, and you can try, if you wish, to maintain mixed breastfeeding (combining breastfeeding with artificial 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 difficulties in establishing a good volume 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 control center for the breastfeeding function in the brain. If the pituitary gland becomes necrotic due to a lack of blood supply, milk production may be insufficient or even non-existent.

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 period, our breast develops, grows, and expands. However, women who have suffered 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 there is any of it remaining in the uterus, this can cause an inhibition of breastmilk coming in. 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 rests that have remained 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 coming in after the period of colostrum. This hypogalactia can be temporary, and the baby needs to be observed during the first days to see the evolution of weight. It should be supplemented with breastmilk or formula if necessary, and you need to wait for the rise of the mature 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.

There can be low breastmilk production that is not related to the mother’s body functions, which can be caused by a limitation of feeding sessions in time and frequency and breastfeeding on a predefined schedule. It can also be affected by the baby’s tongue-tie or poor suckling motions, which can lead to extremely long or ineffective feeds, poor milk transfer, and little weight gain in babies.

Breastfeeding is delicate; an imbalance or irregularity that occurs or has occurred in the mother’s body can cause a lack of milk. 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 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 optimal quality.

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