Worried about Low Milk Supply? you’re Not alone
By Kathleen Stern, IBCLC candidate, Founder - Boston Area Doulas
One of the biggest concerns new parents have is: “Am I making enough milk?”
The good news?
Oftentimes it is “perceived low supply,” and not true low milk supply.
If there is a true low milk supply, it is often manageable once you understand what’s going on.
Milk supply isn’t just one thing—it’s influenced by your body, your hormones, and how feeding gets started.
Some common primary risk factors include:
Little or no breast growth in either puberty, pregnancy or after birth (insufficient glandular tissue)
Hormonal conditions (like thyroid dysfunction or PCOS)
History of infertility
Birth or pregnancy complications (like hypertension or hemorrhage)
Injuries to chest from car accident, or nerve injury of the 4th intercostal nerve
Type 1 or Type 2 diabetes
Hypopituitarism
Secondary low milk supply can develop after birth and is often related to feeding management rather than anatomy. Here are factors that can affect your milk supply after your baby arrives:
Delays in starting breastfeeding
Early or frequent use of formula without pumping or breastfeeding (it is recommended to breastfeed or pump at least 8 times in 24 hrs in the first few weeks to build supply)
Baby’s ineffective latch or milk transfer
Ineffective pumping routines
Improper or prolonged nipple shield use
Estrogen-containing birth control
Certain medications (ex: pseudoephedrine, magnesium, cannabis, nicotine, some SSRIs)
Smoking
Nutritional deficiencies in iron, zinc, and protein
Low calorie intake consistently below ~1500/day
Return of menstruation
Signs to Watch For
It’s not always obvious, but here are a few things that may signal a need for support:
Baby isn’t gaining weight as expected
Fewer wet or dirty diapers (fewer than 6-8 wet diapers or 3-4 quarter-sized poops in 24 hrs)
Feeding feels difficult or painful
Ongoing concern that your baby isn’t satisfied
If you’re noticing these, it’s worth checking in with your pediatrician first, and then an IBCLC for feeding support. Boston Area Doulas would be happy to recommend an IBCLC in your area.
How Support Can Help
If supply is low, the goal isn’t just “more milk”—it’s a feeding plan that works for you and your baby. Support might include:
Improving latch and positioning
Adjusting your pumping routine or renting a hospital-grade pump like the Medela
Protecting your supply while supplementing if needed
And yes, supplementation (with pumped milk, donor milk, or formula) can be a helpful tool, not a failure.
You Don’t Have to Figure This Out Alone
Working with a board-certified lactation consultant (IBCLC) can help you:
Understand the root cause of low supply
Create a realistic feeding plan that supports both baby growth and parent mental health
Reduce stress and second-guessing
Every feeding journey looks different- and getting the right support early can make a big difference.
Bottom line:
Low milk supply is more common than people talk about—and it’s not something you have to push through alone. With the right guidance, most families can find a feeding plan that supports both the baby and your well-being.
