Low Milk Production When Pumping

Important information:

Many people struggle with low milk production for a variety of reasons. With regular breast/chest pumping, milk production gradually increases after delivery. During the first few days of pumping, it is normal to make less than 15 mls or a ½ ounce throughout the entire day. By the end of the first week, you should be producing 500-750 ml (17-25 ounces) per day. If you are pumping for your baby and you are producing less than 500 ml per day (17 ounces), you have a low milk production.

Possible causes of low milk production include:

• Not pumping often enough. You should pump 8 or more times in 24 hours.

• Not pumping overnight. Taking long breaks without pumping will result in low milk production.

• Not emptying breasts/chests completely

• Use of a poor-quality pump or pumping only one breast/chest at a time

• Improper fit of pump flange/breast shield (either too small or too large)

• History of significant engorgement

• Mastitis (may cause a temporary decrease)

• Blood loss during/after birth

• Hypertension (high blood pressure)

• Lack of breast/chest development during pregnancy and after delivery

• Breast/chest surgery or trauma

• Thyroid problems

• Polycystic ovarian syndrome (PCOS)

• History of infertility

• Untreated or poorly controlled chronic diseases such as diabetes

• Obesity

• Anemia

• Smoking

• Anxiety and stress

• Medicines, particularly oral contraceptives containing estrogen and cold medicines containing pseudoephedrine. In addition, if you received steroids during your pregnancy for your baby’s lungs, it may take longer than usual for your milk to fully come in.

Treatment suggestions for low milk production:

If you are not producing 500-750 ml of milk per day, you should:

• Pump both breasts/chests at the same time at least 8 times a day with a good quality electric breast pump.

• Pumping more frequently will increase production more than pumping longer each time.

• Pump until your breasts/chests are empty and milk is no longer flowing, approximately      15-20 minutes.

• Pump at least once between 10 pm and 3 am because this is when your milk-producing hormone levels are highest.

• Use the correct flange/breast shield size (the part that touches your breast/chest). Ask your nurse or lactation consultant to watch you pump.

• Use breast/chest massage before and during pumping and hand expression. To see a           10-minute video that explains how to do breast/chest massage, go to: https://vimeo.com/291806551

• Hold your baby skin-to-skin for an hour at least once daily (if allowed). This will help you to produce more milk. Your milk hormones are stimulated when you are so close to the baby. Pump before and immediately after holding your baby skin to skin.

• Do not smoke or take any medicines that might interfere with milk production.

If more frequent pumping with a good quality double electric pump does not increase milk production within 1 week, call your healthcare provider to discuss treatment options.  Your provider may want to check your hormone levels or examine you for signs of retained placenta fragments.

There are some medicines that reportedly help increase milk production. However, high quality research is lacking. Potential side effects of these medicines must be considered carefully against any potential benefits. If you or your provider would like detailed information about medicines, go to the Academy of Breastfeeding Medicine’s website https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/9-galactogogues-protocol-english.pdf

Herbs have been used by many parents to improve milk production with good results and few side effects. There is little scientific proof that herbs increase milk production. Herbs are not regulated in the United States and there is no way to guarantee purity and dosage of herbal products. Herbs potentially could appear in your milk and produce side effects in your baby so they should be used with caution. You may have heard that certain foods or drinks may increase your milk production but there is no scientific proof supporting this. Eating healthy foods and staying well hydrated will keep you as healthy and energetic as possible.

Medicines, herbs, and diet will NOT increase your milk production if there is infrequent or inadequate breast/chest stimulation and emptying of milk. It is important to treat low milk production as soon as possible. The sooner you make changes to help your body make more milk the more likely you are to provide your baby with the best nutrition possible.  

Reviewed June 2024 by Meghan Devine BSN, RN, IBCLC