If you’ve determined that your milk supply really is low, you may be wondering how to increase milk supply. The first place I want to look is milk removal.
Your body uses milk removal as one of the signals that helps regulate how much milk it produces. Whether milk is being removed by your baby at the breast or by a breast pump, effective and frequent milk removal matters.
So when I’m troubleshooting low milk supply, I want to look at two things:
Efficiency and frequency.
Make Sure Milk Is Being Removed Effectively
The first question isn’t simply, “How often are you nursing or pumping?”
It’s:
“How effectively is milk being removed each time?”
Whether milk is being removed by your baby at the breast or by a breast pump, we need to make sure that milk is actually being removed efficiently.
For breastfeeding, that means looking at whether your baby is transferring milk well. A baby can be at the breast frequently without effectively removing much milk.
Oral function matters. A baby may be working hard at the breast but still have difficulty effectively removing milk. Things like latch, positioning, oral function, oral ties, low tone, prematurity, and other factors can affect milk transfer.
If you’re concerned about milk transfer, a feeding assessment can help us look at what is actually happening during the feeding. In some situations, a weighted feed can also give us useful information about how much milk baby transferred during that particular feeding.
Baby being at the breast is not the same thing as baby effectively removing milk.
Pumping is also a form of milk removal, and the pump needs to be able to do its job effectively.
Milk removal during pumping can be affected by several factors, including:
- Flange fit
- Whether you’re using an effective primary pump for your situation
- Whether your pump parts need to be replaced
- Pump settings
- Breast massage and compression
- Hand expression
- Hands-on pumping
- How the pump is being used
The flange that came with your pump isn’t automatically the right size for you. A flange that doesn’t fit well can affect both comfort and milk removal.
A good flange fit is about more than simply measuring and choosing a size. When assessing flange fit, I want to look at your measurements, how your breast and nipple tissue actually respond while pumping, your comfort, your milk flow, and how much milk you’re able to remove.
Your pump matters, too.
When I’m helping someone who is trying to establish or increase milk production, primary pumps I commonly reach for include Spectra S1/S2, Spectra Gold models, and the Motif Luna.
That doesn’t mean one of these pumps is automatically the right choice for everyone. Pump effectiveness is still individual, and flange fit, pump settings, breast anatomy, pump parts, and how the pump is being used all matter.
I also want to make a distinction between a primary pump and a wearable pump.
Wearable pumps can be incredibly useful, especially when convenience matters. But convenience and milk-removal effectiveness aren’t always the same thing.
If you’re actively trying to increase milk production, I want to know that your primary pump is doing its job before asking you to add more pumping sessions.
That doesn’t mean wearable pumps are bad or that you can’t use one. It means we need to consider what job the pump is being asked to do and which pump you are asking to do that job.
You don’t necessarily need the most expensive pump on the market. You need a pump that is capable of effective milk removal and is actually working well for you.
And this is where techniques like breast massage, breast compression, hand expression, and hands-on pumping can become useful tools.
Dr. Jane Morton and colleagues studied combining hand techniques with electric pumping in mothers of very preterm infants. In that specific population, mothers who used hands-on techniques increased their milk production despite pumping less. Because the study involved mothers of infants born before 31 weeks, we shouldn’t assume the exact results apply identically to every breastfeeding parent—but it provides useful evidence for the idea that your hands can be an important part of the milk-removal process.
Stanford Medicine also provides a hands-on pumping resource developed by Jane Morton that demonstrates techniques for maximizing milk production when pumping.
Your pump doesn’t have to do all the work.
The goal—whether you’re breastfeeding, pumping, or doing both—is the same:
Effective milk removal.
Look at the Whole 24-Hour Picture
Once we’ve established that milk is being removed effectively, the next question is:
How many effective milk removals are happening in a full 24 hours?
We’re looking at the whole day—not just how many times you pumped at work, not just how many times your baby latched, and not just what happened during daylight hours.
For someone who is actively trying to establish or increase milk production, 8–12 or more milk removals in 24 hours can be a useful starting framework, particularly earlier in lactation. But I don’t want you to treat that number like a magic formula.
The number of milk removals a person needs can vary.
Nancy Mohrbacher’s “Magic Number” concept helps explain one reason why: breast storage capacity varies from person to person. That means the number of times someone needs to effectively drain their breasts to maintain milk production isn’t identical for everyone.
So instead of obsessing over whether you hit a particular number, I want you to look at your individual 24-hour pattern.
If your baby breastfeeds six times and you pump three times, that’s nine milk-removal opportunities. But if several of those breastfeeding sessions involve very little milk transfer because of things like oral dysfunction, oral ties, low tone, or prematurity, those sessions may not be equivalent to nine effective milk removals.
Likewise, if you pump six times and nurse three times, that’s nine milk-removal opportunities. But if your flanges aren’t the correct size, your pump isn’t working well for you, your pump parts need to be replaced, or you’re not using effective pumping techniques, those sessions may not be equivalent to nine effective milk removals.
We’re interested in what your breasts are actually experiencing—not just what the clock says happened.
This is why efficiency and frequency are both important to troubleshoot for both breastfeeding and pumping.
Address Missed Milk Removals
This is another piece that can get overlooked.
If your baby normally breastfeeds but starts receiving bottles, your breasts may suddenly be getting fewer milk removals.
If you’re separated from your baby, pumping or hand expression can provide a milk removal when maintaining or increasing milk production is the goal.
The same thing can happen when a baby starts sleeping longer stretches overnight or when a pumping session is consistently skipped.
A missed milk removal here and there doesn’t automatically mean your supply will drop. But a pattern of missed milk removals can matter, particularly when you’re trying to establish or increase milk production.
This is where your individual needs matter. Nancy Mohrbacher’s Magic Number concept helps explain why some people can go longer between milk removals while others need more frequent removal to maintain production.
So rather than thinking, “I have to pump every three hours forever,” think about your overall 24-hour pattern:
How often is milk actually being removed from my breasts?
That’s the frequency side of the equation.
Make It Easier for Your Milk to Let Down
Milk removal isn’t only mechanical.
Your milk also has to let down.
If you’ve ever pumped at home and gotten a decent amount of milk, only to sit at work and suddenly get almost nothing, you’re not imagining it.
Stress, feeling rushed, an uncomfortable pumping environment, or being separated from your baby can make milk ejection more difficult for some parents.
That doesn’t mean you’re doing anything wrong.
And the answer isn’t to simply “relax harder.”
Instead, think about creating an environment that makes milk ejection easier.
Before pumping, you might try:
- A warm compress for a few minutes
- Looking at a photo or video of your baby
- Listening to your baby’s sounds
- Bringing something that smells like your baby
- Giving yourself a few quiet minutes before you start pumping
- Making your pumping space as private and comfortable as possible
These small changes can be especially helpful when your environment is very different from home.
The goal isn’t to force your body to relax. It’s to create conditions that support milk ejection.
Make Sure Your Basic Nutrition and Hydration Needs Are Being Met
Milk production requires energy, nutrients, and adequate hydration. Breastfeeding generally increases your calorie needs by about 400–500 calories per day, although individual needs vary.
That doesn’t mean you need a special breastfeeding diet—or that eating more automatically fixes low milk supply. But consistently under-eating can work against milk production, so I want to make sure you’re getting enough overall nourishment before we start looking for specialized ways to increase supply.
Hydration matters, too. You don’t need to force yourself to drink enormous amounts of water, but you do need to replace the fluids you’re using to produce milk. Keep fluids available, drink regularly, and pay attention to your body’s thirst and hydration cues.
For now, think foundation rather than optimization: eat regularly, get enough overall nourishment, include a variety of nutrient-dense foods, and stay adequately hydrated.
Basic nourishment comes before “milk-boosting” products.
Key Takeaways
Before we say, “Yes, you have low milk supply, and we need to dive deeper,” we need to make sure that:
Milk is being removed effectively?
There is enough effective milk removals across 24 hours?
Missed milk removals are being addressed?
Milk is able to let down well?
Your basic nutrition and hydration needs are being met?
If the answer to those questions is yes and your milk supply is still not responding the way we’d expect, that’s when I want to look deeper.
If the answer is no—or you’re not sure—schedule a consultation with Sarah. We can look at what’s happening, identify where milk removal or milk production may be getting stuck, and make a plan based on what’s actually going on.
The Deeper Dive—What Could Be Contributing to Low Milk Supply?
You’ve made sure milk is being removed effectively. You’re getting enough effective milk removals across the day. You’ve addressed missed removals, you’re supporting milk let-down, and your basic nutrition and hydration needs are being met.
But your milk supply is still low.
This is where I want to stop asking, “What else can you do?” and start asking:
“Why is your body still not making enough milk?”
Because persistent low milk supply can sometimes have a deeper root cause.
Low supply isn’t always a matter of effort, motivation, or not removing milk enough. Sometimes something is affecting the body’s ability to make milk, and adding more milk removals won’t necessarily address the reason it’s happening.
Your pregnancy, birth, medical history, medications, hormonal health, breast development, nutrition, stress, and postpartum recovery can all provide important clues.
What kinds of things can contribute?
There isn’t one single cause of persistent low milk supply. Some of the areas I consider include:
- Hormonal factors, including thyroid and other reproductive or metabolic factors
- Insulin resistance or PCOS, which can affect the hormonal environment involved in milk production
- Insufficient glandular tissue (IGT) or other factors related to breast development and milk-making capacity
- Prolactin or other hormonal issues that affect the process of establishing or maintaining milk production
- Significant blood loss, anemia, or nutritional depletion
- Pregnancy or birth complications, including certain hypertensive disorders or problems with the placenta
- Stress, sleep disruption, or significant postpartum stressors
- Medications or other health conditions that may affect milk production
- Anatomical or other factors that may have been missed earlier
These aren’t diagnoses you should try to make from a blog post. They’re clues that tell me where I may need to look more closely.
And sometimes there isn’t just one contributing factor. Your Milk Supply Mastery framework specifically emphasizes looking for patterns and recognizing that more than one factor may be contributing to a person’s milk supply.
This is where individualized assessment matters
If you’ve gotten the basics right and your supply is still not responding the way we’d expect, I don’t want you to simply keep adding more nursing and/or pumping sessions and hoping something changes.
I want to look at the whole picture.
Your milk-supply timeline.
Your pregnancy and birth history.
How milk production started—or didn’t start—after birth.
Your baby’s milk transfer.
Your pumping and feeding history.
Your breast development and anatomy.
Your medical history and medications.
Your nutrition and postpartum recovery.
And the other clues your body may be giving us.
Sometimes that assessment points to something we can address directly through lactation care. Sometimes it tells us that something deserves further evaluation with your healthcare provider.
The goal isn’t to find a diagnosis on your own. The goal is to recognize when persistent low supply deserves a deeper look.
If this sounds like you…
If you’ve been doing all the “right” things and you’re still wondering why your supply isn’t where you expected it to be, this is a good time to stop adding more and get individualized help.
Schedule a consultation with Sarah. We can look at the whole picture, identify the areas that may be contributing to your low supply, and make a plan for what to address next.
What Else Can We Try?
You’ve looked at the basics. You’ve considered whether there may be an underlying reason for your low supply.
Now we can talk about what else you can actually try.
But I want to approach this differently than the typical “increase your milk supply” list.
There isn’t one magic food, supplement, pumping schedule, or lactation cookie that works for everyone. The strategy that makes sense depends on what your milk supply needs right now.
First: Figure Out What Your Milk Removals Need
Before adding supplements or special foods, I want to look at the milk removals you’re already doing.
There are really two different situations:
If you’re not removing milk often enough
If you’re trying to increase milk production, take a close look at your entire 24-hour milk-removal pattern—not just what happens during the day.
If you’re regularly going long stretches overnight without breastfeeding or pumping, that may be part of the reason your supply isn’t responding the way you’d like.
Nancy Mohrbacher’s Magic Number framework emphasizes both the total number of effective milk removals and the longest stretch between removals. Your individual storage capacity matters, so there isn’t one schedule that works for everyone.
If you’re currently going most of the night without removing milk, adding an overnight breastfeeding or pumping session may be one strategy to consider while you’re working to increase supply.
You don’t necessarily need to maintain that schedule forever. The goal is to increase the milk-removal signal while you’re actively trying to build production and then reassess.
And remember: breastfeeding and pumping both count as milk removals.
If adding another full pumping session feels impossible, power pumping can be another strategy to discuss. Rather than adding another traditional pumping session, power pumping uses a period of repeated pumping and resting to provide additional breast stimulation and milk removal.
The goal isn’t simply to spend more hours attached to a pump.
The goal is to increase effective milk removal in a way that is actually sustainable for you.
If you’re removing milk often enough
Then I don’t necessarily want to tell you to pump more.
Instead, I want to ask:
How can we make the milk removals you’re already doing more effective?
If you’re breastfeeding, that may mean taking another look at baby’s milk transfer.
Have you ruled out oral dysfunction or oral ties that could be interfering with effective milk removal?
Is baby actually transferring milk well?
Would a feeding assessment or weighted feed help us understand what’s happening?
Remember:
Baby being at the breast is not the same thing as baby effectively removing milk.
If you’re pumping, this is where we can troubleshoot the pump itself:
- Is your flange fit appropriate?
- Are your pump settings working well for you?
- Is your primary pump effective?
- Are your pump parts in good condition?
- Are you using breast massage or compressions?
- Have you tried hands-on pumping?
- Are you using hand expression when appropriate?
- Are you relying heavily on a wearable pump when you need particularly effective milk removal?
Your pump doesn’t have to do all the work.
Sometimes small changes to how milk is being removed can be more useful than simply adding more sessions.
Then: Consider What You Can Add
Once we’ve made sure the foundation is solid, there are other strategies we can consider.
Start with food
There isn’t one magic food that will suddenly increase your milk supply.
But once your basic nutrition needs are being met, we can look at foods that are traditionally considered lactogenic—foods that may support milk production as part of an overall nourishing diet.
Foods such as oats, barley, and other nutrient-dense foods are commonly included in lactation-focused nutrition approaches.
The goal isn’t to eat one particular food every day because someone on Instagram told you it will increase your supply.
The goal is to nourish your body well and use food strategically when it makes sense for you.
I’ve also created a MotherFood List with foods you can incorporate into your diet if you’d like to experiment with lactation-focused nutrition.
What about lactation cookies, teas, herbs, and supplements?
This is where things get a little more complicated.
Lactation cookies, teas, powders, and supplements can contain a combination of foods, herbs, vitamins, minerals, or other ingredients marketed to support milk production.
Some ingredients have traditional use in lactation. Some have research behind them. And for many others, the evidence is limited or mixed.
That doesn’t mean they never help.
It means I don’t want you spending money on a cabinet full of supplements before we’ve figured out what we’re actually trying to address.
And “natural” doesn’t automatically mean appropriate for everyone. Herbs and supplements can interact with medications and may not be appropriate with certain medical conditions or situations.
What about herbal galactagogues?
Herbal galactagogues are herbs used with the goal of supporting milk production. They may be worth discussing in some situations.
But I don’t recommend treating them like a universal answer to low milk supply.
If the underlying issue is ineffective milk removal, an herb won’t fix the pump or the latch.
If there is a structural limitation to milk production, the goal may be different.
If there is an underlying hormonal or metabolic issue, that needs to be considered too.
And in some situations, an intervention may not be appropriate at all.
That’s why I prefer to look at the whole picture first and then decide whether a food, herb, supplement, or other strategy actually makes sense.
You Don’t Have to Try Everything
If you’re struggling with milk supply, it can be incredibly tempting to try everything at once.
A new pump.
More pumping sessions.
Power pumping.
Lactation cookies.
Oatmeal.
Teas.
Herbs.
Supplements.
And suddenly you’re spending hours a day trying to increase your milk supply without knowing which thing is actually helping.
More isn’t always better.
Instead, ask:
What are we actually trying to change?
Are we trying to:
- Increase the frequency of milk removal?
- Improve the effectiveness of milk removal?
- Support milk production through nutrition?
- Address a potential underlying contributor?
- Add a targeted strategy while we’re working on the bigger picture?
That’s a very different approach from throwing five supplements into your Amazon cart and hoping one of them works.
Not Sure What to Try Next?
If you’ve worked through the basics and you’re still struggling with milk supply, you don’t have to figure out the next step by yourself.
In a Low Milk Supply Consultation, we can look at your feeding and pumping history, milk removal, baby’s transfer, your pump setup, your pregnancy and birth history, and other factors that may be contributing to your supply.
Then we can decide what actually makes sense to try next—and what you probably don’t need.
[Schedule a Low Milk Supply Consultation]
Because increasing milk supply isn’t about doing everything.
It’s about figuring out what your body needs and choosing the right intervention for the reason your supply is low.