DO I NEED TO WORRY ABOUT LOW MILK SUPPLY?
Low milk supply is one of the most common concerns I see as a Breastfeeding Medicine physician, pediatrician, and IBCLC in Chicago. Unfortunately, by the time many patients find their way to me, we have already lost precious time in figuring out why the supply is low, and in starting to intervene to maximize production. Being aware of potential risks for low milk supply before giving birth can help you prepare and take steps to maximize your chances of successful breastfeeding once the baby arrives.
Risk Factors for Low Milk Supply
Several factors can potentially impact a woman's milk production capacity:
Maternal age over 35: As women age, hormonal changes can affect milk production. However, many women over 35 successfully breastfeed with proper support and management.
History of fertility assistance: Hormonal treatments and underlying fertility issues can sometimes interfere with the natural hormonal cascade required for milk production. This may not change anything about how you would manage your fertility journey, but counseling couples on the implications that infertility may have for one's breastfeeding goals should be part of comprehensive care of infertility.
Underlying chronic medical conditions (e.g., diabetes, high blood pressure): These chronic conditions can affect blood flow to breast tissue and hormone regulation. Proper management of these conditions is important for the mother's health, and understanding that having any underlying medical problem may complicate your breastfeeding journey is important to know ahead of time.
Preeclampsia, high blood pressure, or gestational diabetes during pregnancy: These conditions can delay milk production onset (lactogenesis II) as well as overall milk supply. Careful monitoring and support in the immediate postpartum period are essential.
History of breast surgery, particularly reduction: Depending on the surgical technique, milk ducts and nerves crucial for milk production and let-down may be affected. However, some milk production is often still possible, and there are things you can do early postpartum to maximize your milk production.
Preterm labor: Premature birth can delay milk production, as the breast tissue may not be fully prepared, and the stress of the experience and separation from your baby can compound the effects on supply. Frequent pumping, skin-to-skin contact, and maternal self-care can help stimulate milk production.
C-section delivery: The delay in initial breastfeeding and potential medication effects can impact early milk production. Early and frequent breastfeeding or pumping can help mitigate these effects. Most hospitals these days have care plans that give moms and babies a chance to experience skin-to-skin immediately after the baby is born while still in the operating room.
Separation from the baby after delivery (e.g., NICU admission, maternal complications): Lack of early and frequent stimulation can affect milk production establishment. Pumping as soon as possible and as frequently as the baby would nurse is crucial.
History of low milk supply for a previous baby: Depending on the reason for low milk supply in a previous breastfeeding journey. With each pregnancy, your body increases your milk-making capacity, so a history of low supply can look very different with a second go-around. Having a Breastfeeding and Lactation Medicine physician review your medical history and story may help you determine what caused your low supply last time, and will set you up for a better experience.
It's important to note that having one or more of these risk factors doesn't guarantee low milk production, but it may increase the likelihood.
Steps to Take If You're at Risk
If you identify with any of these risk factors, don't panic. As a breastfeeding medicine specialist in Chicago, I can assure you that there are steps you can take to optimize your milk production:
Reach out for support: Consult with your OB/GYN, an International Board Certified Lactation Consultant (IBCLC), or a breastfeeding medicine physician - or reach out to all three. Having a team of healthcare professionals who can support your journey can make a world of difference for you.
Consider early pumping: In some cases, starting to pump soon after delivery can help establish and maintain milk supply. Please do this with the assistance of a lactation care provider.
Increase emptying sessions: Sometimes, adding just one more breast emptying session per 24 hours can make a significant difference.
Explore supplements: Certain herbs and medications may help boost milk production. Always consult with a healthcare provider before starting any new supplement or medication. This is another situation in which having the help of a physician board-certified in Breastfeeding and Lactation Medicine can be extremely beneficial.
Manage stress: Remember, stress itself can impact milk production. Practice relaxation techniques, find time and ways for self-care, give yourself some grace, and seek emotional support when needed. Perinatal mental health issues are common, and breastfeeding struggles can make postpartum depression and anxiety more likely.
The Importance of Prenatal Preparation
As a pediatrician in Chicago specializing in Breastfeeding Medicine, I cannot stress enough the importance of prenatal preparation with lactation services of some type. Whether it's through a one-on-one lactation consultation, a group class, or discussions with your primary care physician, learning about what to expect can be incredibly helpful.
My 4th Trimester Packages combine in-home pediatrician newborn care with comprehensive basic lactation support and breastfeeding medicine if needed. It is a great option to gift to yourself or to someone you love in the Chicagoland area, especially if you or they had a tough experience with breastfeeding in the past, or you have any of the above-mentioned risk factors.
Support for Your Breastfeeding Journey
For many, providing human milk for one's baby is a feeding goal that carries with it strong emotions. Women who struggle to make "enough" milk for their baby often feel inadequate or like a failure (I put "enough" in quotes because that word is very relative and can have different meanings for different people). While failure and inadequacy this is far from true, my job as a Breastfeeding and Lactation Medicine physician is to help prepare women so that they have appropriate expectations for their journey and have the support they need to provide as much of their breast milk as possible. Part of this medical care includes identifying risk factors for low milk supply prenatally and counseling women on how to take action early to help them succeed in their feeding plans.
If you encounter challenges along the way, don't hesitate to seek help promptly. Early intervention can often make a significant difference in outcomes. And if things don't go as planned, we're here to support you emotionally and help you navigate your journey.
For personalized support or to learn more about my Breastfeeding Medicine and 4th Trimester services in Chicago, visit my website or reach out via email. Together, we can work towards giving you and your baby the best possible start on your breastfeeding and new parenthood journey.