I know the feeling all too well. Everything seems like it’s going along great. You’re exclusively pumping or pumping at work and you’ve gotten into a routine. You’re making enough milk for your baby or your supplementing with formula, but you can pretty much anticipate how much milk you’ll have at the end of each day.
And then BAM! Out of nowhere, your supply seems to take a nosedive. You figure maybe you just had a bad day. But then it happens 2, 3, 4 days in a row. Now you’re panicking. I get it, I've been there.
This can be one of the most stressful moments in a pumping mom's journey. But the good news is that when this happens, there’s usually a reason. And once you figure out what that reason is, it can be possible to fix it.
In this post, I’ll attempt to cover as much as I can about identifying the reasons for a drop in supply and what you can do about it. I will cover the following:
1. How Supply Works
2. How Pumping Complicates Supply and Why It’s so Stressful
3. Hardware: Your Pump + Flange Size
4. Has Your Baby’s Behavior Changed?
5. Has Your Behavior Changed?
6. Hormonal Causes
7. Top Ways to Get Your Supply Back
Of course, you can also contact me with any questions if they’re not answered here.
How Supply Works
To understand how and why we experience a drop in supply, we have to first understand how we make milk in the first place. Milk production begins as a hormonal process. About half-way through pregnancy, the body starts to create colostrum, newborn milk. Colostrum is a very thick, very concentrated form of breast milk and we make it in small quantities. This is on purpose - newborn babies have very small stomachs. After delivery, progesterone (the pregnancy hormone) drops and prolactin levels (milk hormones) rise and trigger mature milk to come in. This process occurs whether we want to breastfeed or not and milk will come in approximately 3-5 days after delivery. As mature milk comes in, the process changes to supply and demand. More milk removal triggers more milk production. This is why milk will eventually dry up if a mom chooses not to breastfeed.
Throughout the first 12 weeks postpartum, our bodies respond very sensitively to the supply and demand process. When nursing, it is important to nurse frequently and on demand so that our bodies adjust to our baby’s needs. At around 12 weeks, our bodies regulate, meaning that our body understands how much milk baby needs, and at this point it becomes harder to increase or decrease supply.
How Pumping Complicates Supply and Why It’s So Stressful
Many women find pumping to be a lot more difficult than nursing a baby. Besides all of the extra accessories you need and cleaning that has to be done, pumping can be challenging when it comes to supply. We know what our baby needs and so we have a very specific number goal in mind each day. While variation in output is totally normal and expected when breastfeeding, it’s much more noticeable when pumping and this adds a lot of stress to the situation.
Unfortunately, even the best pumps on the market are not as effective at removing milk as a well-latched baby. This means that while your body might be completely and totally capable of keeping up with your baby’s demand when nursing, you may struggle with the pump. This isn’t to say it’s impossible to keep up with baby’s demand while pumping - it definitely is for some women. But it can be difficult.
So, now that we have the basics, what is causing this sudden drop in supply?
Hardware: Your Pump + Flange Size
I always suggest starting with the easiest to fix - check your hardware. Duckbill valves, membranes and tubing need to be replaced regularly - the more you use your pump, the more frequently they need to be changed. All of these parts stretch out and lose their shape over time, which will affect suction. You should also check the tubes for condensation, which can lead to lower vacuum strength.
In addition, keep in mind that pumps have shelf-lives. Their motors are typically made to work at full strength for about a year, again, depending on how often you use it. So if this is your second baby on the same pump, you received your pump second-hand, or you’re pumping for a toddler, you may need to consider the age of your pump.
Your flange is another piece of hardware you’ll need to consider since using the correct size is crucial to maximizing output. Even if you’ve had your flange measured (or you’ve measured it yourself), your size can change. If you notice a drop, measure yourself again. If you don’t have an LC who can take a look for you, you can use this handy nipple ruler from Maymom. Just follow the printing instructions carefully so that it prints in the correct size.
Has your baby’s behavior changed?
While less output when pumping can be stressful, it’s not always a bad thing. It may just be a sign that your baby’s needs are changing. This is especially true if your baby is a little older, sleeping through the night, or starting solid foods.
Is your baby nursing less? If you’re pumping some of the time and nursing some of the time, those nursing sessions are having a positive impact on your overall supply. This is because, as we mentioned before, a properly latched baby will always be better at removing milk than the pump. In addition, milk supply is not based on a single session - it’s cumulative. So if your baby has recently started sleeping through the night, you may be missing 1 or 2 nursing sessions, which can definitely trigger a decrease. But this isn’t necessarily a bad thing! If you’re still able to keep up, or are comfortable supplementing, take that extra sleep! You need it and deserve it. If not, you have the option of adding a middle of the night pump which can be very helpful.
Has your baby started solids? If your baby has started eating solid foods, he may require less milk overall. This can cause a chain reaction - he needs less milk, so he takes less while nursing. This sends signals to your body that you don’t need to make as much, which affects your overall pumping output. Again, this isn’t necessarily a bad thing. This is the definition of baby-led weaning, where babies’ nutritional needs and behaviors lead the weaning process. This doesn’t mean that your baby is completely weaning from the breast, but as he gets older and eats more and more solid foods, he will naturally need less milk.
Has Your Behavior Changed?
Sometimes changes in our own behaviors can happen so slowly and subtly that we don’t even realize they’re happening. Take a look at the list below and think about your last week or two to see if anything sounds familiar.
Are you pumping less? Have you been purposely trying to cut back on pumping sessions? If you’re exclusively pumping, you may have heard that as your baby gets older, you can gradually decrease the amount of times a day you pump. While this is true for a lot of moms, there’s no guarantee that as you drop pumps, your milk output will stay the same. In fact, many moms do experience a decrease when they cut pumps. But similar to baby sleeping through the night, your new-found time and freedom may be worth the slight decrease.
Are you frequently missing pump sessions? While you may not be deliberately cutting down on pumping sessions, if you frequently miss one, this can have an effect, as well. Take a look at your calendar from the past few days. You may not even realize that you’ve had a morning meeting every day and had to skip your pump session. Or maybe your baby’s nap schedule changed and when you’ve gone to set up your pumping station, she starts crying unexpectedly, leading you to abandon that session. You may have been inadvertently dropping a pumps.
Have you drastically changed your diet? Breastfeeding is exhausting work and research tells us that breastfeeding moms burn an average of 300-500 extra calories a day! Because your energy and overall health can affect your milk output, it’s important to eat enough calories to keep up. Some people interpret this to mean that an excess of calories will lead to a boost in supply, but this unfortunately isn’t the case for most women. So what exactly does this mean? It means that while over-eating more than your body needs will not boost your supply, under-eating can decrease it. Especially if you’ve made a recent, sharp change. If you’ve changed your diet recently or began restricting your calories, this can definitely be one of the culprits of your suddenly decreased milk supply.
Are you drinking enough water? Similar rules apply for hydration as with calories. While drinking copious amounts of water will not lead to a big increase in supply, you do want to be drinking to eliminate thirst and avoid dehydration. If you’re feeling thirsty, you’re already a little dehydrated, so make sure you’re drinking throughout the day.
Are you getting enough rest? This one almost seems mean, I know. If there’s a new mother anywhere in the world who’s getting enough rest, I’d like to meet her. But again, take a look at your schedule for the past few days. Has something happened that has caused you to get less sleep? Stress at work or home? Is your baby in the middle of a sleep regression? This can be a tougher one to fix, but it can be done. Especially if the lack in sleep is temporary (like a big project at work that will eventually end) or if you have a supportive partner who can get up in the middle of the night during a sleep regression.
Food, Medicines, and Supplements. There are a handful of items that can decrease milk supply when ingested. Perhaps the most well known are decongestants - medicines made to help with a runny nose. These are made to dry you up, so it’s no surprise that they have the ability to dry up milk supply. In addition, certain herbs and spices (when taken in high amounts) can have a negative effect. Take note if you eat a lot of peppermint, parsley, sage, or oregano on a daily basis. Eating them on occasion won’t make much of a difference, though.
The most surprising one on the list is fenugreek. Most people associate fenugreek with an increase in supply, not a decrease. And while it can increase supply in some women, many find it has the opposite effect. If fenugreek is going to have a positive impact on your supply, you’ll notice it within a few days. If you don’t see a difference, stop taking it. Fenugreek also has the ability to negatively interact with certain medications and is contraindicated for women with thyroid issues. It’s important that you speak with your doctor before trying fenugreek (or any new supplements).
Hormonal Changes
Even though it’s true that milk production is a supply and demand system, that system is controlled by the hormones prolactin and oxytocin. Changes in these and other hormone levels can have a direct impact on your milk supply.
Hormonal Birth Control. Have you recently started taking birth control? If so, make sure you talk to your doctor about which methods are best for breastfeeding moms. Many popular forms of birth control are made to manipulate your hormones and can therefore have an effect on your milk production. Generally, progestin-only contraceptives are the preferred choice, but make sure you talk to your doctor if you notice a drop shortly after starting any new method.
Ovulation and menstruation. Ovulation and menstruation are additional processes that are controlled by your hormones, so it may come as no surprise that these can mess with your milk supply. If you haven’t gotten your period in awhile, you may not even realize you're ovulating, which can make this one a little difficult to spot. There is some good news though when it comes to supply decrease due to ovulation and menstruation. First - it’s almost always temporary. When your period is done, your supply will likely come back. Second - some moms have had success with calcium and magnesium supplements (used together). But as always, check with your doctor before starting any supplements, as these could have interactions with other medication or other side effects.
Pregnancy. A sudden decrease in supply could also be an early sign of pregnancy! Contrary to popular belief, it is possible to get pregnant while breastfeeding, especially after your baby starts solids or if you’re pumping. And though it is possible to continue breastfeeding through pregnancy, you will likely notice more colostrum in your milk, in addition to the decreased supply. While this is safe for your baby, it may have a laxative effect. For more information specifically on changes to your milk during pregnancy, you can click here to check out this great article from KellyMom.com.
Looking for a personalized plan to make pumping more effective and get your supply back? Click here.
Top Ways to Get Your Supply Back
It may seem like you’re fighting an uphill battle when so many different things can negatively affect milk supply. And it’s true, there are a lot of things that can cause us to inadvertently decrease our milk, especially for those exclusively pumping. But the good news is that there are things you can do to combat it.
It’s important though, to remember that not every one of these suggestions will work all of the time. For example, if your baby is eating more solids and nursing less, he may be letting you know that he’s starting the weaning process. This doesn’t mean that he’s ready to wean completely, but it could be the start of the natural decrease in milk production. If that happens before you’re ready, it can be emotionally difficult. But, in many of the situations mentioned above, there are things you can do to help.
I often suggest that moms don’t try too many things at once, or you won’t know what’s making the difference. Pick 1 or 2 things to try and give them a few days. If you don’t notice a difference, move onto another method.
Increase Frequency. More frequent milk removal can make a big difference in supply, even if you don’t have time for a full pump or nursing session. You can try:
1. Adding an extra nursing session when you’re with your baby.
2. Adding an extra pump session (or two into your day). Even if it’s only a 5 minute mini-session!
3. Add a Power Pumping session into your day. Power-Pumping is 60 minutes of pumping intended to mimic cluster feeding and increase supply. An increase will not be seen immediately, but may occur slowly over several days. Double pump using the following instructions:
20 minutes PUMP
10 minutes BREAK
10 minutes PUMP
10 minutes BREAK
10 minutes PUMP
More Milk Removal. You’ve got to remove milk to make it, so it’s important that you empty your breasts every single time you pump or nurse. This will tell your body to make more milk! If you think you’ve had trouble emptying in the past or want to ensure you’re emptying in the future, try these techniques:
1. If you’ve been pumping one side at a time, try double pumping. If your baby only nurses on one side per session, try pumping the other side at the same time or immediately after.
2. Increase the length of each pumping session. Make sure you pump until the milk stops flowing and then 2 more minutes. This may allow you to get additional let-downs and express more milk.
3. Use hands on pumping before, during, and after your pump session. Before you start pumping, massage your breasts to help promote the milk flow. While you’re pumping, use your hands to massage in a downward motion, working all around the breast. When you’re finished pumping, hand express to ensure that there is no milk left.
4. Check your flange size. Flange size can change over time and some moms even need two different sizes. Click on this link for a handy printable nipple ruler.
Check your hardware. Your pump has a shelf-life!
1. The average ‘life-span’ of a typical breast pump is 1 year, depending on how often you use it. Keep this in mind, especially if you got your pump second-hand or if you’re exclusively pumping.
2. Check the parts of your pump that affect the suction - the membranes, duckbill valves, and tubing. For casual pumpers, replace every 6 months. If pumping multiple times a day, replace every 3 months. If you notice condensation in the tubing that you can’t get out, replace the tubes right away.
Take Care of Yourself. It’s easier said than done, but try to eat, drink, and sleep as much as your body needs. You don’t need to go overboard on any of them - drinking 200oz of water is not going to be a magic bullet. But you do want to drink until you’re not thirsty and eat until you’re not hungry.
Remove Stress. Again, it’s easier said than done, but if you can at least remove stress and adrenaline while you’re pumping or nursing, it can help your supply. Try to put yourself in a happy place by listening to upbeat music, a relaxing podcast, or even meditating. Focus on positive and happy imagery. If you’re pumping, look at pictures or videos of your adorable baby and allow your heart to feel that squishy, I-want-to-eat-your-feet feeling. Some moms even see a difference when they watch happy, emotional, or funny videos online. All of these things will help you relax and lower the amount of adrenaline pumping through your blood.
If you’ve got questions about a sudden drop in supply, leave a comment below or shoot me an email.
Happy Pumping!
- Sandy -