Low milk supply
[2] Several common misconceptions often lead mothers to believe they have insufficient milk when they are in fact producing enough.
[3] Actual low milk supply is likely if the baby is latching and swallowing well at the breast, is nevertheless not growing well or is showing signs of dehydration or malnutrition, and does not have a medical condition that would explain the lack of growth.
One study found that 15% of healthy first-time mothers had low milk supply 2–3 weeks after birth, with secondary causes accounting for at least two-thirds of those cases.
[3] Many medications are known to significantly suppress milk production, including pseudoephedrine, diuretics, and contraceptives that contain estrogen.
[5] One aspect of supply regulation that has been identified is that breast milk contains a peptide called feedback inhibitor of lactation (FIL).
[4] A woman's belief that her milk supply is insufficient is one of the most common reasons for discontinuing breastfeeding.
[4] The Ten Steps of the Baby Friendly Hospital Initiative describe some maternity hospital practices that promote the development of a good milk supply, such as rooming in (allowing mothers and infants to remain together 24 hours a day) and having trained staff available to help mothers with breastfeeding.
Newborns who are immediately placed on their mother's skin have a natural instinct to latch on to the breast and start nursing, typically within one hour of birth.
Immediate skin-to-skin contact may provide a form of imprinting that makes subsequent feeding significantly easier.
[6] For mothers of healthy term infants who are able to nurse, very strong evidence supports improving breastfeeding practices as a primary treatment.
[5] Increasing skin-to-skin contact between mother and baby, and allowing unrestricted breastfeeding, aid in stimulating the milk ejection reflex and promote frequent feeds.
[2] After the above treatment methods have been attempted, many breastfeeding specialists and lactation consultants recommend medications or herbs that are believed to increase milk supply (galactagogues).
[5] In 2010, a randomized, double-blinded, placebo-controlled study demonstrated that domperidone increased milk production in mothers of preterm infants.
[5] In some cases, especially when low supply is caused by medical conditions such as insufficient glandular tissue, long-term use of supplements is necessary.
