Postpartum tips for low milk supply: a practical, encouraging guide
If you’re worried about low milk supply, you’re not alone—and you’re not doing anything wrong. Most supply problems can be improved with the right support and a few targeted changes. This guide offers evidence-based, mom-tested strategies you can start today, plus clear signals for when to seek extra help. You deserve care and confidence as you nourish your baby and recover.
Understand how milk supply works (and what’s normal)
Milk production runs on supply and demand. The more effectively and frequently milk is removed, the more your body is signaled to make. In the first 3–5 days postpartum, milk “comes in” (lactogenesis II). Frequent feeding and skin-to-skin during this time help set your long-term supply. Cluster feeding (very frequent feeds, often in the evenings) is normal and helps boost supply.
Signs your baby is getting enough include: swallowing sounds during feeds, softening of your breasts after feeds, at least 6 wet diapers and 3–4 yellow, seedy stools per day after day 4–5, and steady weight gain after the first week. Most infants lose up to 7–10% of birth weight in the first days and then regain it by about 10–14 days. If diapers or weight gain are below these ranges, connect with your pediatrician and a lactation consultant for a feeding plan while you work on supply (AAP; ABM Protocol recommendations).
First steps: optimize latch, positioning, and milk transfer
Effective milk removal is the foundation of supply. A deep, comfortable latch helps your baby transfer milk well and protects nipples from damage.
Step-by-step for a deep latch: 1) Get comfy and bring baby to you. Use pillows to support your back, arms, and the baby. 2) Position baby tummy-to-tummy with you, ear–shoulder–hip in a straight line, nose level with your nipple. 3) Support your breast with your hand behind the areola, fingers away from the nipple. 4) Tickle baby’s upper lip with your nipple and wait for a wide, gaping mouth. 5) Quickly bring baby onto the breast, aiming the nipple toward the roof of the mouth, so more of the lower areola is in the mouth than the upper. 6) You should feel strong tugs, not pinching. Re-latch if painful after the initial seconds. 7) Use breast compressions during active sucking to increase milk flow.
Try different positions (laid-back, cradle, cross-cradle, football) to see what gives the deepest, most comfortable latch. If feeds are persistently painful, baby seems frustrated, or weight gain is low, get in-person help to assess latch and milk transfer and to evaluate for issues like tongue-tie by a qualified clinician. Weighted feeds (pre- and post-feed weights) with an IBCLC can objectively show how much milk baby transfers per session.
Feed early and often, and practice responsive feeding
In the newborn period, offer the breast at least 8–12 times in 24 hours. Don’t watch the clock—watch your baby. Early hunger cues include stirring, bringing hands to mouth, and rooting; crying is a late sign. Allow baby to finish the first breast and then offer the second. Night feeds matter for supply because prolactin levels are higher overnight. Lots of skin-to-skin (as much as you can, especially in the first weeks) increases feeding cues, improves milk transfer, and supports supply.
Use hand expression and “hands-on” techniques
Hand expression can be especially effective in the first days when milk volumes are small and colostrum is thick. It also complements pumping to increase output.
Hand expression steps: 1) Wash hands and relax shoulders. Gentle warmth or a brief breast massage helps. 2) Place your thumb and fingers about 1–1.5 inches behind the nipple in a “C” shape. 3) Press back toward the chest wall, then compress thumb and fingers together and roll forward—don’t slide on the skin. 4) Rotate around the areola to drain different ducts. Collect drops in a spoon or small cup.
“Hands-on pumping” (massaging and compressing during pumping, then hand-expressing after) has been shown to increase milk volume and fat content in expressed milk for many mothers.
Pumping to boost supply: when and how
If baby isn’t removing milk well yet, or if you’re separated, add pumping to protect and build supply. A typical goal in the early weeks is 8 or more milk removals per 24 hours (any combination of feeds and pumps).
Step-by-step pumping plan: 1) Choose the right pump. A double electric pump is helpful for building supply; hospital-grade rentals can be valuable in the first weeks if supply is low or baby is preterm. 2) Fit your flanges. Measure your nipple diameter after a brief pump and choose a size that’s typically 1–3 mm larger than your nipple. Signs of good fit: nipple moves freely without rubbing, minimal areola pulled in, comfortable suction, and good output. 3) Frequency: If baby is latching but transfer is low, add 2–3 pumping sessions daily after feeds. If baby isn’t latching or you’re exclusively pumping, aim for 8 sessions per 24 hours, including one overnight. 4) Duration: Pump 15–20 minutes. If milk flow stops earlier, use “finish with hand expression” for 2–5 minutes more. 5) Try a power-pump once daily for 3–7 days: pump 20 minutes, rest 10, pump 10, rest 10, pump 10. Evidence is limited, but many parents find it jump-starts supply. 6) Stay comfortable: Use the fastest cycle speed that is comfortable to trigger letdown, then decrease speed and increase vacuum to a comfortable level for milk expression. Pumping should not hurt.
If supplementation is needed, protect breastfeeding
Sometimes babies need more milk while you build supply. That’s okay. You can supplement in ways that support breastfeeding. The preferred order of supplements is your expressed milk, then pasteurized donor milk, then formula when needed. Work with your pediatrician and IBCLC to determine volumes. In the first days, physiologic supplement volumes are small and gradually increase; appropriate amounts help meet baby’s needs without overstretching the stomach.
Ways to supplement while protecting breastfeeding: 1) Offer the breast first for active sucking and bonding. 2) Supplement using paced bottle feeding, a supplemental nursing system (tube at breast), cup, or syringe—methods that let baby control flow and reduce preference for fast-flow bottles. 3) If using a bottle, use a slow-flow nipple, keep baby upright, and pause frequently to mimic breastfeeding. 4) “Triple feeding” (short breastfeed, then supplement, then pump) can be used short-term to boost supply while ensuring intake. Keep sessions efficient: 10–15 minutes at breast, supplement as needed, then pump 10–15 minutes. Reassess every 48–72 hours with your IBCLC to scale back as supply and transfer improve. Protect your rest by sharing tasks and prioritizing sleep blocks.
Care for your body: small changes that matter
Your recovery and health influence supply.
Helpful habits: - Eat regular, balanced meals and snacks. You don’t need a special diet; aim for enough calories to satisfy hunger and support healing. - Drink to thirst. Extra fluids beyond thirst don’t boost supply, but dehydration can reduce output. - Rest whenever possible. Enlist help with household tasks so you can focus on feeding and recovery. - Skin-to-skin and rooming-in increase milk-making hormones and feeding cues.
Medical factors to address with your clinician: - Significant postpartum blood loss, retained placental fragments, thyroid disorders, insulin resistance/PCOS, anemia, and certain medications can reduce supply. Screening and treatment can help. - Medications and substances: Combined estrogen-containing contraceptives may decrease supply, especially in early weeks; progestin-only methods are usually preferred initially. Some decongestants (pseudoephedrine) and high-dose antihistamines can lower supply. Nicotine can interfere with let-down. If you drink alcohol, do so sparingly and avoid nursing during peak levels; alcohol can transiently reduce milk ejection. Use the LactMed database or ask your provider to check medication compatibility with breastfeeding.
Galactagogues (milk-boosting medications or herbs): what to know
Non-drug strategies (effective milk removal, frequency, latch, and addressing medical issues) are the first-line, most proven ways to increase supply. When these are optimized, some families consider galactagogues under clinician guidance.
- Prescription options: Domperidone and metoclopramide can increase milk in some situations (strongest evidence in mothers of preterm infants). Both require medical supervision. Domperidone is not FDA-approved in the U.S. and may increase the risk of heart rhythm problems; metoclopramide can cause mood changes and other side effects. These should only be used after careful risk–benefit discussion and monitoring. - Herbal options: Fenugreek and other herbs have limited, low-quality evidence and potential side effects or interactions (e.g., fenugreek can cause GI upset and is not appropriate for some conditions). If you use herbs, do so with guidance from a knowledgeable clinician and stop if side effects occur.
When to seek extra help and red flags
Get prompt support if: - Baby has fewer than 6 wet diapers per day after day 4–5, fewer than 3–4 yellow stools, persistent jaundice, lethargy, or isn’t gaining adequately. - Nursing is persistently painful, nipples are damaged, or you suspect mastitis (worsening breast pain, redness, fever, flu-like symptoms). - You have concerns about your mood or anxiety; mental health is health, and support is available.
Reach out early to an International Board Certified Lactation Consultant (IBCLC), your pediatrician, or a breastfeeding medicine clinician. Early, skilled help can turn things around quickly.
Encouragement and next steps
Your bond with your baby is not defined by ounces. Every drop of milk and every cuddly feed counts. Focus on one or two changes at a time: improve latch, add a daily power pump, or increase skin-to-skin. Reassess in a couple of days. Celebrate small wins, and lean on your support team. You’ve got this—and you don’t have to do it alone.
Helpful resources
- Find an IBCLC: International Lactation Consultant Association (ILCA) directory. - La Leche League International: Peer support and helplines. - WIC Breastfeeding Support: Lactation help and pump access for eligible families. - LactMed (NIH): Medication safety during breastfeeding. - Academy of Breastfeeding Medicine (ABM) clinical protocols: Evidence-based guidance for clinicians and parents.
References
American Academy of Pediatrics. Policy Statement: Breastfeeding and the Use of Human Milk (2022). https://publications.aap.org/pediatrics/article/150/6/e2022057988/190346
HealthyChildren.org (AAP). How can I tell if my baby is getting enough breast milk? https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/How-to-Tell-if-Baby-Getting-Enough-Milk.aspx
World Health Organization. Ten Steps to Successful Breastfeeding. https://www.who.int/health-topics/breastfeeding#tab=tab_2
Academy of Breastfeeding Medicine. Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate (Revised 2017; updates 2022). https://www.bfmed.org/protocols
Academy of Breastfeeding Medicine. Clinical Protocol #9: Use of Galactogogues in Initiating or Augmenting the Rate of Maternal Milk Secretion (2018). https://www.bfmed.org/protocols
Morton J et al. Combining hand techniques with electric pumping increases milk production and fat content in mothers of preterm infants. Journal of Perinatology. 2009;29(11):757–764. https://www.nature.com/articles/jp200913
Centers for Disease Control and Prevention. Breastfeeding your baby: How much and how often? https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/index.html
National Library of Medicine. LactMed Database (Alcohol; Pseudoephedrine; Metoclopramide; Domperidone). https://www.ncbi.nlm.nih.gov/books/NBK501922/
American College of Obstetricians and Gynecologists. Optimizing Support for Breastfeeding as Part of Obstetric Practice (Committee Opinion) and Postpartum Contraception guidance. https://www.acog.org
Academy of Breastfeeding Medicine. Clinical Protocol #36: The Mastitis Spectrum (2022). https://www.bfmed.org/protocols
USDA WIC Breastfeeding Support. https://wicbreastfeeding.fns.usda.gov
This guide is for general education and does not replace personalized care. For individual guidance, connect with your pediatrician, obstetric provider, and an IBCLC.