Your Pregnancy Matters

4 factors that can decrease breast milk supply – and how to replenish it

Your Pregnancy Matters

Image Here
It sounds difficult, particularly with a newborn, but try to limit your stress. It is the No. 1 killer of breastmilk supply, especially in the first few weeks after delivery.

In February 2022, the largest producer of infant formula in the U.S. was shut down amid an FDA investigation and recall due to reports of bacterial contamination at its Michigan plant. By early May, about 40% of formulas were out of stock, with more than half sold out in Texas and five other states, according to news reports.

The U.S. Department of Health & Human Services has issued a resource list, with guidance to help families in the wake of the shortage. Breast milk banks such as Mothers Milk Bank of North Texas can potentially bridge feeding gaps for some families with newborns.

On May 16, the FDA and the baby formula manufacturer agreed to a deal that would reopen its Michigan plant, but it could be six to eight weeks before parents will begin to find the products such as Similac back on store shelves. Under the consent decree, Abbott agreed to meet certain benchmarks required by the FDA and ensure its facility met all safety guidelines.

The surprising formula shortage has naturally increased the focus on breastfeeding as a nutritious and economical option for many families. But switching to exclusive breastfeeding – or increasing your supply – is not as easy as flipping a switch.

The amount of breast milk a woman can produce after childbirth depends on a variety of factors. Some are not within her control, but some can be managed with extra planning and support from friends and family.

What can reduce breast milk supply?

1. Feeling stressed or anxious

Stress is the No. 1 killer of breastmilk supply, especially in the first few weeks after delivery. Between lack of sleep and adjusting to the baby’s schedule, rising levels of certain hormones such as cortisol can dramatically reduce your milk supply. I’ve seen women who, within 24 hours, have gone from having an ample milk supply to literally none due to stress.

The last few years living through the COVID-19 pandemic have certainly increased anxiety for many pregnant women and families with young children. Adding the supply chain issues and reduced manufacturing of formula can take its toll on a woman’s stress and anxiety levels.

I tell all my patients that while breastfeeding is important, mental health is key to properly caring for a baby. If you or a loved one notice that you’re having symptoms of stress, anxiety, or postpartum depression, it’s important to connect with your health care provider and get adequate care. While many new moms want to do everything themselves, I encourage you to seek and accept help from your partner, family members, and friends so you can rest, recover, and maintain an adequate milk supply for your baby. They cannot breastfeed a baby, but they can help with cooking, laundry, household chores, and running errands.

2. Supplementing with formula

After your baby is born, the breasts operate on supply and demand. Exclusively breastfeeding drives higher demand, so the breasts create more milk. However, supplementing with formula for multiple feedings every day (such as while the baby is at daycare) or releasing breast milk only when the baby wants to nurse tells your body that it doesn’t need to produce as much milk. Consequently, your supply will begin to decrease.

You can counteract this by pumping at regular feeding intervals throughout the day. Pumping tells the body to continue producing, even if the baby isn’t eating at that moment. Breast milk keeps well in the freezer, so pump at work if you can and store it for later use.

Breast pumps come in a variety of shapes and sizes, from large electric pumps to smaller handheld options. Hands-free wearable breast pumps are a relatively new option. Battery-powered, they use integrated cups that fit inside a bra and attach to breast milk containers through small tubes. These pumps can fit discreetly under work clothes and offer a moderate suction level for pumping on the go.

Related reading: 5 things to know about buying and using breast pumps

3. Eating or drinking too little

It can be tempting to diet after giving birth to lose “baby weight.” Make sure to eat enough to replenish the 500 calories breastfeeding burns each day. Consider eating a healthy snack, such as an apple with nut butter, between meals to close the calorie gap.

Adequate hydration also is important for breast milk production. The amount of liquid you put into your body affects how much breast milk you can produce. I encourage women to carry a bottle of water for themselves in their diaper bag. When my children were babies, a friend told me to drink a glass of water every time I nursed. It was an easy way to remember to drink enough, and I pass that tip along to my patients. 

4. Getting sick

Just catching a virus or bug such as the flu, a cold, or a stomach virus won’t decrease your milk supply. However, related symptoms such as fatigue, diarrhea, vomiting, or decreased appetite definitely can.

Ask for help at home when you’re sick so you can continue to make enough breast milk to nurse or pump for the baby. And be sure to get your COVID-19 vaccine – it has been proven safe and effective for pregnant and breastfeeding patients.

“Stress is the No. 1 killer of breastmilk supply, especially in the first few weeks after delivery. Between lack of sleep and adjusting to the baby’s schedule, rising levels of certain hormones such as cortisol can dramatically reduce your milk supply.”

–Shivani Patel, M.D.

A few ways to replenish your milk supply

All is not lost if you notice a decrease in your milk production. Follow these tips to help replenish the supply:

● Pump a little extra: Increase the frequency of your pumping, and make sure your breasts are completely empty after each feeding. Even if your baby isn’t hungry, pumping every two instead of three hours for a few days will rev up the body’s supply and the “demand” process and produce more milk.

Image Here
Pumping consistently should rev up the body’s "supply and demand” process and produce more milk.

● Double pump: After you’ve nursed the baby and pumped the remaining milk, lay your baby down to sleep. Then, drink a glass of water, wait 20 minutes, and pump again. Do this every time you nurse or pump for 24 to 48 hours and you should see a boost.

● Use milk-producing products: Eating oatmeal can help increase your breast milk supply, as can hoppy beers that contain a lot of yeast. There also are products such as mother’s milk cookies and teas that are thought to increase milk production. The main ingredient in these is fenugreek, a seed that also is available as a supplement.

The formula shortage is alarming, and the U.S. Food & Drug Administration is working to improve access to infant and specialty formulas through swift manufacturing changes and efforts to maximize production at more facilities.

If you choose to breastfeed, consider visiting with a certified lactation consultant to give you and your baby the best start. These experts can help you work around factors that make breastfeeding challenging.

Remember, the end goal is the same, regardless of the feeding method: a healthy baby and a healthy mom.

To talk with an Ob/Gyn doctor or lactation consultant, call 214-645-8300 or request an appointment online.