Sudden Drop in Milk Supply: Causes, Signs, & Solutions

By Dr. Kenosha Gleaton, OBGYN

Breastfeeding can be a beautiful way to bond and nourish your baby. Many public health organizations highly recommend exclusively breastfeeding for at least the first six months of a baby’s life and continuing to nurse in addition to introducing new foods for as long as you and your baby would like. [1] Breastfeeding has been shown to provide the perfect amount of nutrients to a baby, help boost a baby’s immune system, lower the risk of sudden infant death syndrome (SIDS), and can even help speed up postpartum recovery.  [1] 

If you’re concerned about your milk supply, you’re not alone. Most new parents tend to worry about their milk supply, whether they have an oversupply of milk, a slow let-down reflex, or experience a drop in their milk supply. Let’s talk more about what could be causing low milk supply and what you can do to support your breastfeeding journey. 

Is a Decrease in Breast Milk a Serious Issue?

Breast milk production tends to work by supply and demand. The more frequently you nurse or pump, the more your body will produce. [2] If you’ve recently cut back on feedings or have adjusted your nursing schedule, it makes sense that your body may react by slowing down milk production. Other factors can also play a role in your milk supply, like nutrition, hormone levels, and more. If you aren’t experiencing other symptoms, the main concern with a decrease in breast milk is ensuring your baby is getting plenty of nutrients. If you do notice a drop in your milk supply, use pumped milk or formula to keep your baby satisfied and reach out to a provider to get a better understanding of what could be going on. Learn the pros and cons of formula feeding vs breastfeeding → 

3 Signs That Your Milk Supply is Decreasing

First, it’s important to know how much milk you should be producing and what is normal for a newborn or infant to eat. In the first few days postpartum, it’s normal for a newborn to only consume about 450 ml of colostrum/breast milk per day. [2] This amount will gradually increase as the days go by, climbing to 800 ml by day five postpartum. [2] For the first six months of life, infants tend to consume up to 1220 ml every day, while nursing anywhere from six to twelve times a day. [2] 

Some people tend to produce a high volume of milk, while others may have difficulty producing enough. Many factors play a role in this, including genetics, seasonal factors, nutrition status, and more. [4] So how can you tell if your milk supply is decreasing? Here are some signs to look out for. 

Infant Weight Gain

One of the most important indicators of health in an infant is their weight. It’s vital that your baby is consistently gaining weight and growing, which is also a sign that they are getting enough nutrients through their diet. [3,5] You should check in with your baby’s doctor if you’re concerned they aren’t gaining enough weight. 

Decrease in Dirty Diapers

Another way to ensure that your baby is eating enough is by keeping track of their wet and dirty diapers. [3,5] A baby’s poops can tell you a lot about their health and how much they’re eating. If you notice your baby is producing fewer wet or dirty diapers all of a sudden, you should consult a healthcare provider. A provider can also give you a better idea of how many dirty diapers are normal vs abnormal depending on your baby’s age. 

Signs of Dehydration

Dehydration is a serious condition that can quickly become dangerous, so it’s important to know the signs and symptoms. Some signs to look out for include [6]:

• Parched, dry mouth
• Urinating less frequently
• Fewer or no tears when crying
• Sunken soft spot on the head
• Fussiness
• Sleepiness
• Sunken eyes
• Cool or discolored hands and feet
• Wrinkled skin

These are just a few signs to look out for if you’re concerned you aren’t making enough milk. If you ever notice any new, strange, or confusing symptoms arise in yourself or your baby, you should consult a healthcare provider.

7 Potential Reasons Your Milk Supply is Decreasing  

So what causes a decrease in milk supply? Here are some key factors that can influence milk production and breastfeeding. 

Stress & Lack of Sleep

Postpartum life can be exhausting and stressful. You’re adjusting to your new family member and likely aren’t getting as much sleep as you’d like. While more data is needed, there does seem to be a correlation between stress, the let-down reflex, and milk production. [7-8] Specifically, studies show that high cortisol levels (brought on by stress and lack of sleep) can disrupt the let-down reflex, and may even slow down milk production over time. [7-8] Learn how you can prepare for breastfeeding while pregnant. 

Illness

The body is pretty incredible, and will often continue to produce milk that is high in antibodies when a nursing parent falls ill. A simple cold or virus by itself isn’t likely to decrease your milk supply, but related symptoms like diarrhea, vomiting, decreased appetite, or fatigue can. [9] If you do come down with something, talk with your provider about what treatments are breastfeeding safe, and whether or not you need to supplement with formula while you recover. 

Alcohol and Drug Use 

It is possible to have an occasional drink when breastfeeding, as long as you wait at least two hours after a single drink to nurse. [1] However, drinking more than two drinks per day regularly may be harmful to your baby and could lead to diminished milk supply. [1] Similarly, using tobacco or other drugs can be very harmful to your health, your baby's health, and your milk supply. [1,3] Some prescribed medications or supplements can also impact your milk production, so be sure to clear any new products with a provider before taking them. 

Underlying Conditions

Some underlying conditions, including diabetes, herpes, thyroid disease, hepatitis B, and hepatitis C can impact breast milk supply. [3] If you have been diagnosed with any chronic conditions or are experiencing new symptoms associated with any of these conditions, you should contact a provider. 

Less Demand

Milk production is highly influenced by demand, meaning the more you nurse or pump, the more milk the body will produce. [2,4] If you have begun to supplement with formula, or have introduced solid foods to your baby before they are 4-6 months old, you may notice a decrease in your supply. [3,9] An insufficient latch can also lead to your baby consuming less milk, which may decrease production. [3] 

Insufficient Diet

The body works hard to produce enough milk for your baby while also supporting your basic needs. It’s important that you fuel your body with plenty of healthy foods and water while nursing.  According to the American College of Obstetrics and Gynecology (ACOG), breastfeeding parents need to consume an additional 450 to 500 calories every day. [1] Your body also needs to be adequately hydrated to produce breast milk, so be sure to drink a lot of water and eat hydrating foods. [2,4] 

Onset of Menstruation

The onset of menstruation while breastfeeding can lead to changes in milk supply. Your first postpartum period can appear as early as five weeks after giving birth and as late as 12 weeks after giving birth. [12-13] The onset of menstruation can vary greatly depending on your genetics, hormone levels, breastfeeding schedule, etc. [12-13] Many nursing parents have reported a drop in their milk supply during the luteal phase, which is the second half of the cycle leading up to menstruation. [12] 

This isn’t a comprehensive list of factors that can influence milk supply. To get a better idea of what might be impacting your milk production, speak with a healthcare provider. 

What to Do If You've Had a Sudden Drop in Milk Supply

If you have noticed a sudden drop in your milk supply, your first step should be making an appointment with your provider. It’s important to keep them informed of any changes you notice while breastfeeding, and they may be able to help you pinpoint any underlying causes. Aside from talking to a provider, the best way to encourage milk supply is to breastfeed frequently. [1-4] Continue to nurse, pump, and hand express as often as you can. Your body should boost milk production to keep up with increasing demand. Here are some more tips to encourage milk supply [1,3,9,10,11]:

• Ensure your child is latching properly
• Empty both breasts after each feeding. After your baby has stopped nursing, hand express or pump any remaining milk. You can also try double pumping by waiting 20 minutes after completely emptying your breasts, drinking some water, and pumping again. 
• Prioritize rest. It can be hard to get a lot of sleep when you’re caring for a newborn, but it’s extremely important that you find some time to rest. Don’t be afraid to reach out to a family member or friend for help if you need time to nap or relax. Support self-care while breastfeeding with our breastfeeding kit or nourishing nipple balm. 
• Eat a healthy diet. Make sure you are eating enough to fuel your body and milk production. ACOG recommends eating around 2,500 calories every day if your weight is in the normal range. [1] Your diet should consist of fruits, vegetables, lean protein, dairy, whole grains, and low-mercury seafood two to three times a week. [1] 
• Stay hydrated. Along with a healthy diet, adequate hydration is also extremely important for milk supply. It’s recommended that nursing parents consume about 16 cups of water every day, which can come from food, beverages, and plain drinking water. [10] Don’t forget to supplement your electrolytes from time to time as well, especially if you’ve recently been sick, had diarrhea, or have been sweating. 
• Try different galactagogues. Lactation-inducing substances can be found in prescription medications as well as supplements, foods, and herbal teas. One study found mixed results when studying the effectiveness of galactagogues like fennel, cumin, barley, chasteberry, coriander, ginger, dill, and many others. [11] 
• Massage your breasts. This can help with milk let-down. 

How Natalist Can Help

Breastfeeding has many mental and physical benefits, but can sometimes be challenging. Breastfeeding parents often experience some sort of complication when nursing, such as cracked nipples, mastitis, clogged ducts, etc. If you are concerned about how much milk you’re producing or how much your baby is eating, you should speak to a healthcare provider. Some key takeaways are to increase the frequency of your feedings/pumping, drink plenty of water, eat a balanced diet, and increase your caloric intake. Sometimes your healthcare provider may suggest continuing to take prenatal vitamins for women or postnatal vitamins to support the high nutritional demand during breastfeeding. [1] Have more questions about postpartum life or nutrition? Check out the Natalist blog. 

References:

1. Breastfeeding Your Baby. ACOG. Updated December 2022. https://www.acog.org/womens-health/faqs/breastfeeding-your-baby. Accessed January 2024. 
2. 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.
3. Low Milk Supply. WIC Breastfeeding Support. USDA. https://wicbreastfeeding.fns.usda.gov/low-milk-supply. Accessed January 2024. 
4. Golan Y, Assaraf YG. Genetic and Physiological Factors Affecting Human Milk Production and Composition. Nutrients. 2020;12(5):1500. Published 2020 May 21. doi:10.3390/nu12051500
5. How Much Milk Your Baby Needs. WIC Breastfeeding Support. USDA. https://wicbreastfeeding.fns.usda.gov/how-much-milk-your-baby-needs. Accessed January 2024. 
6. Vega RM, Avva U. Pediatric Dehydration. [Updated 2023 Aug 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK436022/
7. 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
8. 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
9. Patel, Shivani. 4 factors that can decrease breast milk supply – and how to replenish it. UT Southwestern Medical Center. May 2022. https://utswmed.org/medblog/decrease-breast-milk-supply/ Accessed January 2024. 
10. Gordon, Barbara. Eat Right. Academy of Nutrition and Dietetics. Nursing Your Baby — What You Eat and Drink Matters. April 13 2022. https://www.eatright.org/health/pregnancy/breastfeeding-and-formula/nursing-your-baby-what-you-eat-and-drink-matters. Accessed January 2024. 
11. Foong SC, Tan ML, Foong WC, Marasco LA, Ho JJ, Ong JH. Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants. Cochrane Database Syst Rev. 2020;5(5):CD011505. Published 2020 May 18. doi:10.1002/14651858.CD011505.pub2
12. Menstruation and Breastfeeding. La Leche League International. January 2021. https://llli.org/breastfeeding-info/menstruation/. Accessed January 2024. 
13. Sharman A. Menstruation after childbirth. J Obstet Gynaecol Br Emp. 1951;58:440-445.

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.