Breastfeeding involves natural fluctuations in milk production that adjust to the infant’s needs. Changes, such as softer breasts after the first few weeks, often indicate the body is becoming more efficient rather than signaling a problem. However, a genuine decrease in breast milk supply, sometimes called “drying up,” can occur. Recognizing the difference between perceived low supply and an actual reduction is necessary to ensure the baby receives adequate nutrition.
Maternal Indicators of Decreased Supply
A noticeable change in breast texture is one of the earliest signs of decreased supply. Breasts that previously felt firm or heavy before a feeding may begin to feel consistently soft and less full, even after a significant period without nursing or pumping. This softer texture signals that the mammary glands are holding less milk between sessions.
The let-down reflex is the physiological process that pushes milk out of the breast. Mothers who typically felt a tingling, warming, or mild cramping sensation when their milk released may notice this feeling has become significantly reduced or is absent entirely. While not all women feel the let-down, a sudden disappearance of a previously strong sensation can indicate reduced milk flow.
For mothers who use a breast pump, a sustained drop in the volume of milk expressed is a clear warning sign. While pumping output normally varies, a consistent decline over several days, especially during historically high-yield times, warrants investigation. This sustained reduction suggests the body is receiving fewer demand signals to produce milk.
Infant Behaviors Suggesting Insufficient Intake
The most reliable signs of insufficient milk intake are observed in the baby’s output and weight gain patterns. A baby who is not getting enough milk will show a distinct change in their elimination schedule. After the first few days of life, a baby should have at least six large, heavy wet diapers per day with pale or clear urine; fewer than this is a concerning sign.
A reduction in the frequency of bowel movements is also an indicator, especially in the first six weeks. Newborns typically have at least three to four yellow, seedy, and loose bowel movements daily after the fourth day of life. A baby consistently producing fewer than this number, or whose stools remain dark green or small after the first week, may be receiving inadequate milk volume.
Infant behavior during feeding can also signal an issue. A baby may become unusually fussy or agitated at the breast, pulling off frequently, or exhibiting a weak, fluttery suck without the deep, rhythmic swallows that indicate effective milk transfer. Alternatively, a baby may become excessively sleepy at the breast, falling asleep quickly without completing a full feed, which suggests insufficient calorie intake.
The most serious sign of insufficient intake is poor weight gain or weight loss after the initial post-birth period. A healthy breastfed baby should regain their birth weight by 10 to 14 days of age and then gain approximately 5 to 7 ounces per week for the first four months. Failure to meet these milestones suggests the baby is not getting the nutrition required for healthy development.
Lifestyle and Health Factors Affecting Milk Production
Milk production operates on a supply-and-demand mechanism. Any factor that interferes with milk removal can lead to a drop in supply. Inadequate or infrequent breast emptying is a common cause, such as a poor latch, feeds spaced too far apart, or missed pumping sessions. When milk is not effectively removed, the body signals production to slow down.
Hormonal shifts influence milk supply, as lactation is a hormone-driven process. The return of the menstrual cycle, often several months postpartum, can cause a temporary dip in supply due to changing hormone levels. Similarly, a new pregnancy while breastfeeding can reduce milk volume and change the milk’s taste due to elevated progesterone.
Certain medications interfere with the hormones responsible for milk synthesis. Estrogen-containing medications, such as some hormonal birth control pills, are known to reduce supply. Some common over-the-counter decongestants may also have a drying effect on milk production. Chronic maternal stress, illness, or fatigue can negatively affect the body’s ability to produce milk by interfering with the release of oxytocin, which is responsible for the let-down reflex.
When to Consult a Lactation Professional
Seeking professional help is warranted when persistent signs of low supply do not resolve with basic measures. If the baby is not regaining their birth weight by two weeks or is failing to gain weight consistently, a consultation with an International Board Certified Lactation Consultant (IBCLC) is advisable. An IBCLC can perform a weighted feed to accurately measure the volume of milk the baby transfers at the breast.
If the baby’s diaper output remains consistently low (fewer than six wet diapers or three bowel movements per day after the first week), this needs immediate professional attention, as it indicates inadequate intake. Other signs for consultation include experiencing persistent pain during feeding or dealing with constant anxiety about supply. An IBCLC can assess the latch, evaluate the baby for physical issues, and develop a personalized plan to safeguard the baby’s nutrition and support the mother’s feeding goals.