Does Stress Affect Milk Supply? A Comprehensive Look

By Dr. Kenosha Gleaton, OBGYN

The Connection Between Stress and Milk Supply

While many new parents hope and believe that breastfeeding will be an easy, natural process, this isn’t always the case. It can be difficult to get into a good rhythm when breastfeeding, and many new parents run into some difficulty when attempting to breastfeed for the first (or the second or third) time. Finding a comfortable and adequate latch, supporting milk production, waking up regularly to breastfeed or pump, and experiencing mastitis or other uncomfortable conditions, are just a few of the potential obstacles you may face. [1] Today, we’re going to discuss how maternal stress impacts milk supply and what you can do to encourage healthy milk production. 

Stress and the Let-Down Reflex

A vital part of breastfeeding is something known as the let-down reflex. The let-down reflex controls milk flow and is triggered by certain feelings, sensations, and other stimuli. [1] When a baby suckles on the breast, oxytocin is released and tells the body that it’s time to breastfeed, causing the milk ducts and surrounding muscles to contract and expand, allowing milk to flow. Multiple studies have found that this let-down reflex can be impaired by maternal stress. [2] Emotional stress as well as physical stress or pain can cause milk to stop flowing, making it more difficult to breastfeed or pump. [1-2] 

It is important to note that this pathway between stress and milk production could also be reversed in some cases, meaning delayed or inadequate milk production could actually be causing maternal stress. More research is needed to fully understand the relationship between these factors. [2] 

The Role of Cortisol in Milk Production

While more data is needed, there does seem to be a correlation between stress, the let-down reflex, and milk production. As previously mentioned, experiencing stress, which is often measured through cortisol levels, may have the ability to impact the let-down reflex. [2] Other data also suggest that if this reflex is regularly impacted, milk production may also suffer over time. [2-3] Lactation is highly related to supply and demand, meaning that the body will usually produce more if the demand for milk stays high. This means pumping, breastfeeding, or hand expressing regularly is key for telling your body to continue producing milk. [1] If the let-down reflex is preventing milk flow, the body may assume demand isn’t as high and slow down milk production. [2-3] Other research has corroborated this, finding that mothers experiencing family stress, gender-based violence, household responsibilities, and other stressful circumstances had decreased milk production when compared to those experiencing less stress. [4] Stressful life circumstances are particularly common in those with lower income and little access to resources or support.  [4] 

How Stress May Impact Your Breastfeeding Journey

Not only can stress affect the let-down reflex and potentially milk production as a whole but maternal stress has been shown to impact breastfeeding in other ways as well. Research shows that high cortisol levels can actually be measured in breast milk. [5] Higher cortisol concentrations in breast milk are associated with increased infant weight gain, as well as increased fat and lactose content in breast milk. [5-6] Additionally, continued levels of stress are more likely to result in early cessation of breastfeeding. [7] Stress may cause a decrease in milk production and let-down, which may result in painful or engorged breasts, a fussy baby, or added stress and discouragement. If you are having difficulty breastfeeding or have concerns about how much your baby is eating, be sure to speak to a healthcare provider. 

Coping Mechanisms: Reducing Stress for Better Milk Supply

You may not be able to change some stressors in your life, but finding healthy coping mechanisms and relying on your support system can help support your breastfeeding journey. Let’s talk about the importance of relaxation, self-care, and support systems. 

The Importance of Self-Care and Relaxation

If anyone deserves a bit of self-care, it’s a new mom. Be sure to prioritize you-time in between diaper changes, cleaning, pumping, and other responsibilities. Find what helps you relax and schedule it in as regularly as possible. Whether it’s taking a warm bath, reading a book, or getting out of the house for a bit, finding ways to pamper yourself may help lower stress levels. It’s also important to seek out professional help when needed. If you ever feel as though you may benefit from counseling, don’t be afraid to reach out to your healthcare provider. If you’re looking for more ways to promote self-care from home, check out Natalist self-care products, including Magnesium Plus, Nip & Lip Balm, Cooling Cream, and more. 

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Creating a Positive Breastfeeding Environment

Another way to support a positive breastfeeding experience is to create a calming, positive environment. Studies show that stress responses can appear as a result of hearing, feeling, or seeing stressful stimuli. [2,5] If you’re feeling stressed or having difficulty producing milk, try moving to a more relaxing space. You may want to use calming scents, play relaxing music, and turn off harsh lighting. Find a comfortable position that works for you and baby and see if you notice a difference in your let-down reflex or overall production. 

The Role of Support Systems

Data shows that a lack of support may further contribute to maternal stress, potentially leading to decreased milk production or milk flow. [4] While asking for help is sometimes easier said than done, make sure you’re leaning on your loved ones as much as possible. Parenting is hard, and the first few weeks and months with a newborn can be extremely exhausting. Remember that you are not in this alone and your partner, friends, and family are likely all willing to lend a helping hand. Whether you need someone to run an errand for you, change a diaper, clean up your dishes, etc. finding ways to lean on your people can be extremely helpful for alleviating a bit of stress. If you don’t have the people or resources in your life at this point to lean on, speak to a healthcare provider or search online for any local community resources or groups you can connect with. 

While there are many health benefits associated with breastfeeding, not everyone chooses to or is able to breastfeed. If you don’t think breastfeeding is right for you, that’s okay. Speak to a healthcare provider about supplementing with infant formula. 

How Natalist Can Help

Natalist is proudly led by a team of moms, doctors, and parents who understand the ups and downs of fertility, pregnancy, and postpartum life. Our goal is to provide products that are science-backed, sustainable, and empowering for the entire parenting journey. If you’re in need of postnatal vitamins, male fertility products, fertility-friendly drink mixes, or anything in between, we’ve got you covered. Check out our product selection here, or read more on the Natalist blog. 

References:

1. Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals. Geneva: World Health Organization; 2009. SESSION 2, The physiological basis of breastfeeding. Available from: https://www.ncbi.nlm.nih.gov/books/NBK148970/
2. Kathryn G. Dewey, Maternal and Fetal Stress Are Associated with Impaired Lactogenesis in Humans, The Journal of Nutrition, Volume 131, Issue 11, November 2001, Pages 3012S–3015S, https://doi.org/10.1093/jn/131.11.3012S
3. Dewey KG. Maternal and fetal stress are associated with impaired lactogenesis in humans. J Nutr. 2001;131(11):3012S-5S. doi:10.1093/jn/131.11.3012S
4. Piccolo, O., Kinshella, ML.W., Salimu, S. et al. Healthcare worker perspectives on mother’s insufficient milk supply in Malawi. Int Breastfeed J 17, 14 (2022). https://doi.org/10.1186/s13006-022-00460-1
5. Katie Hinde and others, Cortisol in mother’s milk across lactation reflects maternal life history and predicts infant temperament, Behavioral Ecology, Volume 26, Issue 1, January-February 2015, Pages 269–281, https://doi.org/10.1093/beheco/aru186
6. Ziomkiewicz A, Babiszewska M, Apanasewicz A, et al. Psychosocial stress and cortisol stress reactivity predict breast milk composition. Sci Rep. 2021;11(1):11576. Published 2021 Jun 2. doi:10.1038/s41598-021-90980-3
7. Dozier AM, Nelson A, Brownell E. The Relationship between Life Stress and Breastfeeding Outcomes among Low-Income Mothers. Adv Prev Med. 2012;2012:902487. doi:10.1155/2012/902487