Breastfeeding: my milk supply is not enough, what can I do?

If your baby has tongue tie or gets used to feeding when sleepy, this can affect the latch, which in turn can affect a good feed. Nipple shields and other instruments may also affect latch. While any of these issues are being addressed, you might want to consider expressing your milk alongside breastfeeding if the latch is less than ideal.

Pumping your breasts after nursing or in between can be helpful. You could try pumping for 5 minutes or so after a session and there is no more milk coming out, to maximise stimulation.

Offering each breast at every feed is important: let baby finish on one side, and then offer the second side. Holding your baby close skin-to-skin as often as you can also help with breastmilk stimulation.

Minimise distractions when you are nursing and avoid letting baby nurse while they are sleepy. At the time when you are trying to increase milk supply, avoid things like dummies, bottles and formula milk, because the more time away from the breast, the less stimulation your breasts receive to trigger more milk production.

Breastfeeding is thirsty work, so make sure you stay well hydrated, resting when you can, maintaining a good nutritious diet and trying to keep a handle on anything that causes you stress or anxiety as breastfeeding can be sensitive to this.

Domperidone or metoclopramide are two medications that can be used to increase a mother’s milk supply. These work by blocking a hormone called dopamine in the brain, which inhibits another hormone called prolactin from working. This results in higher prolactin levels, which encourages more milk production.

These work best for women who, for a variety of reasons, may have a low level of prolactin. They are not suitable for everyone.

In the UK, doctors are reluctant to prescribe you these medications, as they are off-licence, which means that this use is not what the manufacturer intended. You also risk significant side effects such as depression, seizures and heart problems.

If it is something you are considering, it will be worthwhile discussing with your doctor or a lactation expert for more advice. But remember that poor latching on to the nipples and ineffective feeding are the most common causes for insufficient milk production, so these must always be addressed first.