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Low milk supply - Part 2

What causes a low milk supply?
Your breasts produce milk to match your baby's demands. The more he feeds, the more milk you’ll produce. So if your supply does dip temporarily, there has to be a good reason.

It's possible your milk supply might dip if breastfeeding is disrupted, for any of these reasons:

- Your nipples are sore and feeding hurts.
- You’re giving your baby a dummy, which cuts the amount of time that he’s at your breast in each 24 hours.
- You’re trying to feed on a four-hourly routine rather than on demand.
- Your baby is sleepy and needs coaxing to feed.
If your newborn is very sleepy, you may need to wake him and gently encourage him to feed more often. This will stimulate your breasts to produce more milk.

If your baby is difficult to wake or doesn’t feed well, try expressing some colostrum or milk and giving it to him in a bottle. This will satisfy your baby's needs, and encourage your milk supply to build up at the same time.

Milk supply is sometimes affected by medical conditions. See your GP if any of these apply to you:

- You have a hormonal disorder, for example, if your thyroid level is low (or, in some cases, high).
- You’ve had breast surgery or a breast injury in the past.
- You’ve lost a large amount of blood during or after labour. Your milk supply may be affected until you recover.
- There’s a fragment of placenta still lodged in your uterus (womb). This may stop your breastmilk production until it’s passed or removed.
- You’re taking certain medicines. Medicines such as the combined contraceptive pill or a cold remedy with a decongestant such as pseudophedrine can affect your supply.
However, in most cases of suspected low milk supply, the real problem is not about how much milk you have. It's about how much milk your baby is able to get at.

If your baby isn’t latching on well, he'll struggle to get enough of your milk. Take a look at our visual guide to help you decide if your baby is latching on properly.

There's also plenty of expert help available. Ask your midwife or health visitor if she can recommend a breastfeeding specialist, or look at our directory of breastfeeding organisations.
What can I do to boost my milk supply?
Once you've checked your baby is latched on properly, you could also try the following:

- Let your baby feed on demand, as often and for as long as he wants. Always allow him to finish the first breast before offering him the second.
- Give your baby only breastmilk. It may be tempting to top him up with a bottle of formula. However, if you satisfy your baby's hunger with formula, he will need less breastmilk and you won't produce as much.
- Try not to give your baby a dummy.
- Try expressing your milk after each feed. Removing leftover milk in your breasts will help you to produce more milk.
Will a low milk supply affect my baby?
If your baby often needs more milk than he gets, he might grow more slowly than other babies of his age. This is called failure to thrive. Call your doctor and make an appointment right away if your baby isn’t gaining weight, or is losing weight. In most cases, improving your breastfeeding technique will be enough to solve the problem.

If you have a very low milk supply, breastfeeding specialists may suggest a drug called domperidone.

Domperidone isn’t licensed to be used to boost milk supply. It's an anti-nausea drug. However, a side-effect is that it increases the levels of a hormone called prolactin in your blood. Prolactin kick-starts milk production in the first days after childbirth.

Your GP would need to prescribe domperidone. You would need to use it alongside, rather than instead of, other methods of boosting your milk supply. Talk to a breastfeeding counsellor or specialist if you want to know more.

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