Low Milk Supply

Perceived Low Milk Supply

There are many reasons why mothers PERCEIVE they are not making enough milk, when in fact they are. Breastfeeding is a confidence game. If a mother interprets infant feeding behavior or breast changes as a loss of milk supply she may decide to supplement the infant with formula, leading to a decrease in production due to less frequent feedings at the breast. Changes in feeding routines that mothers may interpret as low supply include:

  • Feeding more frequently than expected
  • Infants with a high suck need
  • Constant infant fussiness
  • Infant rejection of the breast
  • Decline in breast fullness after 2-4 months postpartum
  • Decrease in infant stooling
  • Bottle preference

Mothers should be encouraged to see a provider or lactation specialist to help determine if these changes are due to low supply or something else. An infant weight is crucial to sort this out. Therefore, this is not an evaluation that can be done over the telephone.




  1. Marasco, LA Unsolved Mysteries of the Human Mammary Gland: Defining and Redefining the Critical Questions from the Lactation Consultant’s Perspective J Mammary Gland Biol Neoplasia (2014) 19:271-288
  2. Rudel RA, Fenton SE, Ackerman JM, Euling SY, Makris SL Environmental Exposures and Mammary Gland Development: State of the Science, Public Health Implications, and Research Recommendations Environ Health Perspect 119:1053-1061 (2011)
  3. Anderson AM Disruption of Lactogenesis by Retained Placental Fragments JHL 17(2) 2001 p. 142-144
  4. Matsuzaki S, Endo M, Ueda Y, Mimura K, et al A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage BMC Pregnancy and Childbirth (2017) 17: 188
  5. Souteiro P., Belo S, Carvalho D. Dopamine agonists in prolactinomas: when to withdraw? Pituitary 2019 Sept 25
  6. Hoover KL, Barbalinardo LH, Platia MP Delayed Lactogenesis II Secondary to Gestational Ovarian Theca Lutein Cysts in Two Normal Singleton Pregnancies JHL 18(3) p. 264-268
  7. Aljazaf K, Hale TW, Ilett KF, et al. Pseudoephedrine: Effects on milk production in women and estimation of infant exposure via breastmilk. Br J Clin Pharmacol 2003;56:18–24
  8. McGuire Ee. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012;20:32-4.
  9. Lactmed National Institutes of Health Drug and Lactation Database https://www.ncbi.nlm.nih.gov/books/NBK501922/ (accessed 12/14/19)
  10. Stuebe A, Bryant AG, Lewis R, Muddana A Association of Etonogestrel-Releasing Contraceptive Implant with Reduced Weight Gain in an Exclusively Breastfed Infant: Report and Literature Review Breastfeeding Med 11(4) 2016 p. 203-206
  11. Farr A, Chervenak FA, McCullough LB, Baergen RN, Grunebaum A. Human placentophagy: a review A J Ob Gyn April 2018 p 401- 410
  12. Stuebe AM, Meltzer-Brody S, Pearson B, Pedersen C Grewen K. Maternal Neuroendocrine Serium Levels in Exclusively Breastfeeding Mothers Breastfeeding Med 10(4) 2015 p. 197-202