Postpartum for Beginners: A Warm, Practical Guide to Low Milk Supply
If you’re worried about low milk supply, you’re not alone—and you’re not failing. Many new mothers question their supply in the early weeks, and there are effective, evidence-based steps you can take right now to protect your baby’s intake and increase your production. This guide will walk you through what’s normal, how to tell if supply is truly low, and exactly what to do—gently and step-by-step—so you can move forward with confidence.
How Milk Supply Works (and Why That Matters)
Breastmilk production is a “supply-and-demand” system. When milk is removed often and effectively, your body makes more. Hormones (prolactin and oxytocin) support this process, especially in the first weeks when your milk supply is being “programmed.” Frequent milk removal in the first 2–4 weeks is one of the strongest predictors of later supply (AAP, 2022; ABM Protocols).
What this means for you: small, frequent feeds or pump sessions—especially overnight—signal your body to increase supply. Long gaps or ineffective milk removal send the opposite message.
Is It Really Low Supply? What’s Normal vs. Concerning
Many normal newborn behaviors can mimic low supply: cluster feeding in the evenings, fussiness during growth spurts (often around days 2–3, weeks 2–3, and week 6), and wanting to be at the breast for comfort. These alone don’t mean your supply is low.
More reliable signs your baby is getting enough include: by day 4–5, at least 6 wet diapers and 3–4 yellow, seedy stools in 24 hours; good alertness and tone; and steady weight gain after the initial weight loss. Most babies lose up to 7–10% of birth weight in the first days and should regain birth weight by 10–14 days (AAP HealthyChildren). If diapers are scant, baby seems very sleepy or jaundiced, or weight gain is below expectations, contact your pediatrician and a lactation professional the same day (CDC; AAP).
First Things First: Make Milk Removal Frequent and Effective
These non-pharmacologic steps have the strongest evidence and lowest risk. Try them for several days consistently; many parents see a noticeable increase in 3–7 days.
1) Feed or pump at least 8–12 times per 24 hours, including overnight. Don’t wait for crying; offer at early cues (stirring, rooting, fingers to mouth). Night sessions matter because prolactin is higher at night (AAP; CDC).
2) Ensure a deep, comfortable latch. Aim baby’s tummy to your tummy, nose opposite the nipple, chin touching the breast first, and wait for a wide-open mouth before bringing baby on. You should feel tugging, not pinching; cheeks stay rounded; you hear or see swallows. If it’s painful after the first sucks, break the seal gently and relatch. Consider an in-person latch check with an International Board Certified Lactation Consultant (IBCLC).
3) Practice skin-to-skin contact. Hold your baby skin-to-skin on your chest for 60+ minutes a few times a day. This boosts feeding cues, milk ejection, and breastfeeding success (Cochrane Review, Moore et al., 2016).
4) Use breast compressions during feeds and pumps. When baby’s sucking slows, squeeze and hold the breast to increase milk flow. This can improve transfer and stimulate more production.
5) Add hand expression, especially in the early weeks. Hand expression right after feeds or pumping can increase output and support supply. Combining massage, hand expression, and pumping (“hands-on pumping”) increases milk volume (Morton et al., 2009; Stanford Medicine).
6) Optimize pumping. If direct breastfeeding is limited or baby is sleepy or premature, use a high-quality (ideally hospital-grade) double electric pump. Pump 15–20 minutes, both breasts, at least 8 times in 24 hours. Check flange size: your nipple should move freely in the tunnel with about 1–3 mm space and minimal areolar pull. Use a comfortable suction level (more is not always better). A short “power pumping” session (e.g., pump 20 min, rest 10, pump 10, rest 10, pump 10) once daily may help some parents, though evidence is limited.
7) Avoid long stretches without milk removal. In the early weeks, try not to go longer than 3–4 hours, even overnight. If baby receives a bottle, pump during or shortly after to “replace” that removal session.
Protect Your Baby While You Build Supply
When intake is borderline or baby has weight concerns, short-term supplementation can be a bridge—not a failure. The goal is to feed the baby and protect your supply while you address the cause (ABM Protocol #3).
Here’s a step-by-step “triple feeding” plan (temporary):
1) Offer the breast first for 10–20 minutes with breast compressions to maximize transfer.
2) Supplement if needed with expressed breast milk, pasteurized donor milk, or formula. Start with small, frequent amounts as directed by your pediatrician/IBCLC. Use paced bottle feeding, cup, spoon, syringe, or a supplemental nursing system (SNS) to reduce flow preference (ABM Protocol #3; La Leche League International).
3) Pump or hand express for 15–20 minutes right after the supplementation to signal your body to make more. Consider combining pumping with hands-on techniques.
Triple feeding is intense. Aim for 24–72 hours, then reassess with your pediatrician/IBCLC to adjust supplements as supply and transfer improve. Build in rest: cluster your support, nap when possible, and consider skipping 1–2 pump sessions in 24 hours for mental health if baby is well fed and weight is monitored.
How Much Supplement?
Amounts depend on your baby’s age, size, and weight trajectory. Your pediatrician/IBCLC can tailor volumes. As a rough guide, early days may require small, frequent amounts; by weeks 2–4, typical daily intake for exclusively breastfed infants averages 24–30 oz (700–900 mL), but individual needs vary (AAP). The key is frequent reassessment and gradual weaning of supplements as transfer and weight gain improve.
Find and Fix Common Causes of Low Supply
Sometimes the issue isn’t milk-making ability but milk transfer. Consider these possibilities and seek help tailored to you:
Baby factors: Prematurity, jaundice, sleepiness, oral anatomy differences (such as tongue-tie), or inefficient suck can limit transfer. An IBCLC can assess a feed, do a weighted feed, and coordinate with your pediatrician or a specialist if needed (AAP; ABM).
Maternal factors: Severe postpartum bleeding, retained placental fragments, thyroid disorders, anemia, insulin resistance/PCOS, insufficient glandular tissue, previous breast surgery, and certain medications can reduce supply (CDC; ABM). If you had a significant hemorrhage, experience delayed milk “coming in” beyond day 3–5, or notice minimal breast changes in pregnancy/postpartum, ask your clinician for evaluation and labs (e.g., thyroid function, iron studies).
Medications that may lower supply include estrogen-containing birth control, decongestants like pseudoephedrine, and dopamine agonists (cabergoline/bromocriptine). Discuss safer alternatives (e.g., progestin-only contraception in the early postpartum) with your clinician (CDC; LactMed).
Engorgement and swelling: Post-birth IV fluids can cause breast edema, making latching difficult. Gentle reverse pressure softening around the areola for 1–2 minutes before latching can help milk flow and improve latch.
Galactagogues: What to Know About Medications and Herbs
Galactagogues are substances used to increase milk production. They should be considered only after optimizing frequent and effective milk removal, and after addressing latch/transfer and medical issues.
Pharmaceutical options: Domperidone and metoclopramide may increase milk modestly in some cases. Domperidone is not FDA-approved in the U.S. and can cause cardiac side effects (QT prolongation); metoclopramide may cause fatigue, depression, and other central nervous system effects. If considered, this should be under clinician supervision with appropriate screening and follow-up (ABM Protocol #9; Cochrane).
Herbal options: Fenugreek, moringa (malunggay), blessed thistle, goat’s rue, and others are commonly mentioned. Evidence for most is limited or mixed, and herbs can have side effects or interact with medications (fenugreek may cause GI upset, maple-syrup body odor, can worsen asthma, and may affect blood sugar or interact with warfarin). Discuss any herb with your clinician and pharmacist, especially if you have medical conditions or take other medications (ABM Protocol #9; LactMed).
Hydration and nutrition: Drink to thirst and aim for a balanced diet. There’s no strong evidence that specific foods dramatically boost supply, though some parents find oatmeal or certain soups comforting. Extreme calorie restriction may hinder supply; most lactating parents need modest additional calories (CDC).
A Gentle 72-Hour “Supply Boost” Plan
Day 1
• Hold baby skin-to-skin for at least 60 minutes, 2–3 times. Offer the breast at every early cue. Add two extra pumping sessions (e.g., mid-morning and evening) for 15–20 minutes, using hands-on techniques.
• Check latch with an IBCLC if you have pain or baby is not transferring well. Begin breast compressions during every feed.
Day 2
• Continue 8–12 feedings in 24 hours; avoid long gaps. Add one “power pump” if you can. If supplementing, use paced feeding and pump after to protect supply.
• Track diapers and, if possible, arrange a weight check or weighted feed with an IBCLC to confirm intake.
Day 3
• Maintain frequency. Focus on restful, nourishing meals and hydration to support energy. Review medication list with your clinician. If progress is limited, discuss whether there’s a transfer issue, a medical factor to treat, or whether a galactagogue is appropriate in your case.
Taking Care of You
Your rest and mental health matter. Low supply can feel stressful and isolating. It’s okay to adjust goals, to combine breast and bottle, and to choose what sustains your well-being while nourishing your baby. Postpartum mood changes are common; if you notice persistent sadness, anxiety, intrusive thoughts, or trouble sleeping even when you have the opportunity to rest, reach out to your clinician or Postpartum Support International for help. You are doing an amazing job.
When to Get Help Now
• Fewer than 3–4 stools per day by day 4–5, fewer than 6 wet diapers per day after day 4–5, very sleepy baby, signs of dehydration, or persistent jaundice.
• Ongoing nipple pain, cracked nipples, or baby struggling to latch.
• Weight loss beyond 7–10% in the first days, not regaining birth weight by 10–14 days, or slow weight gain afterward.
• History of severe hemorrhage, retained placenta, thyroid disease, or PCOS—ask for targeted evaluation.
Helpful Resources
• An IBCLC can create a tailored plan, check latch and transfer, and coordinate care with your baby’s clinician.
• Consider local breastfeeding clinics, WIC breastfeeding support, La Leche League meetings, or hospital-based lactation services.
References and Trusted Sources
• American Academy of Pediatrics (2022). Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics. https://publications.aap.org
• AAP HealthyChildren.org. How to Tell if Your Baby is Getting Enough Milk. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Is-My-Baby-Getting-Enough-Milk.aspx
• Centers for Disease Control and Prevention (CDC). Low Milk Supply. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/problems/low-milk-supply.html
• CDC. Maternal Diet and Breastfeeding. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html
• National Library of Medicine, LactMed. Pseudoephedrine; Fenugreek. https://www.ncbi.nlm.nih.gov/books/NBK501922/ and https://www.ncbi.nlm.nih.gov/books/NBK501779/
• Academy of Breastfeeding Medicine (ABM) Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate. https://www.bfmed.org
• ABM Clinical Protocol #9: Use of Galactogogues in Initiating or Augmenting Maternal Milk Production (2018). https://www.bfmed.org
• Cochrane Review: Early skin-to-skin contact for mothers and healthy newborns (Moore et al., 2016). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003519.pub4/full
• Morton J et al. (2009). Combining hand techniques with electric pumping increases milk production. Journal of Perinatology. https://www.nature.com/articles/jp200913
• Stanford Medicine Newborn Nursery. Hand Expression of Colostrum and Hands-on Pumping. https://med.stanford.edu/newborns.html
• La Leche League International. Bottles and Other Tools; Paced Bottle Feeding. https://www.llli.org/breastfeeding-info/bottles/
Remember: low supply has solutions. With the right support, frequent and effective milk removal, and a plan that fits your life, most parents see improvement. However you feed, you are providing love, comfort, and nourishment—your baby is lucky to have you.