Low Milk Supply with an ‘Older Baby’
Many mothers become concerned about their milk supply as their baby gets older (over 2 months) - especially if a mother is away from her baby for work or school. See a lactation consultant for an evaluation if you are concerned.
- As babies gets older, they become more efficient at the breast. A baby over 2 months of age may drain the breast in 3 to 5 minutes. Your baby may also nurse less often – every 3 to 5 hours rather than every 2 to 3 hours. Your breasts may not feel as full and you may be less aware of let-down. This can all be normal. Average intake for a baby 1 to 6 months old is 25 ounces a day
- How do you know if your baby is gaining well? The best way is to use a growth chart. http://www.cdc.gov/growthcharts/data/who/grchrt_girls_24lw_9210.pdf
Plot as many weights as you have available to see if your baby is following the expected curve. At 3 months of age, normal gain is approximately 4 to 7 ounces per week. At 6 months of age, normal gain is approximately 2.5 to 4 ounces per week. If you have questions, please talk to your doctor or make an appointment with one of our lactation consultants
- If you do determine that your supply is low (baby is not content after the breast and/or is not gaining weight well), try to nurse your baby more frequently when you are together. If your baby seems distracted while nursing, offer your breast at the end of his/her nap. Many “older” babies nurse better when they are drowsy.
- While nursing, try breast compressions as baby slows down his/her swallowing. Gently compress your breast tissue and listen for swallows. When swallowing stops, rotate your hand on your breast and compress again. Keep doing this until you do not hear any more swallows, or your baby refuses to continue.
- Older babies are less patient with a slow milk flow. If you want to increase your production, you will need to use a breast pump to remove the milk your baby is leaving in your breasts. Start by pumping after every feeding and using breast compressions until you cannot get any more milk. A video demonstrating this can be found at: http://newborns.stanford.edu/Breastfeeding/ MaxProduction.html
- You may want to add either a middle of the night feed or an early morning feed to both increase intake and increase supply. If your baby is not waking in the night, try waking your baby. Most babies will nurse well and immediately return to sleep.
- If your baby is over 4 months and eating solids (finger foods, cereal, or baby foods), always offer the breast before solids at home. Have your day care provider offer solids before milk at day care, especially if they are giving your baby pumped breast milk in a bottle. A sippy cup may help your baby be satisfied with less milk at daycare.
- Always try to nurse after you get to day care (before you go to work or school) and again when you get to day care before you take baby home. This decreases the amount of time that your breasts go without stimulation or milk removal from your baby.
- Try to decrease the amount of time between pumping at work. How often you pump is more important than how long you pump. Try to pump more frequently, but for shorter time periods (three 10 minute pumping sessions rather than two 15 minute pumping sessions). Even one extra 5 minute pumping session may help.
- Consider renting a Symphony hospital grade rental pump, which is often more effective than the Pump In Style (PNS) Advanced or Freestyle. (See our information on Using A Double Electric Breast Pump.) Some mothers find the PNS Advanced more effective than the Freestyle.
- You may try to “power pump” daily, or several times a week, to mimic cluster nursing and a growth spurt. Pump for 12 minutes, break for 12 minutes, pump for 12 minutes, break for 12 minutes, pump for 12 minutes over the course of an hour.
- Calm music and meditation have both been shown to increase prolactin levels, which may help to boost your milk supply and help you cope with a busy life.
- You may want to try a galactagogue like fenugreek, blessed thistle, goat’s rue or Go-Lacta. However, the real key is milk removal. If you are not removing milk, by your baby or a pump, a galactagogue will be of little help. (See our information on Not Enough Milk.)
- Some mothers find that their supply decreases with the return of their menstrual cycle. You may find that a calcium/magnesium supplement (1000mg/500mg) taken daily helps prevent this.
- Avoid pseudoephedrine (an ingredient found in decongestants, such as Sudafed). This medication is considered safe for you to take, but may significantly decrease your milk supply. Other substances that may decrease supply include peppermint/menthol, and large amounts of sage and parsley.
- All hormonal birth control methods CAN decrease your milk production. (See our information on Hormonal Methods of Birth Control.) You may want to consider a barrier method if you suspect your birth control has decreased your milk supply.
- Realize that you have two full-time jobs if you are working outside the home and nursing your baby. Do not fill your weekends with errands and activities. Spend time breastfeeding and being close to your baby. Breastfeeding is a short term investment that has long term benefits for you and your baby