Milk supply is the number one reason mothers stop breastfeeding early or reach for formula. The good news is that most of what protects and builds your milk supply comes down to a few simple things you can control. This episode breaks down how milk production actually works, how to gauge your supply accurately, and why so many mothers worry they are not making enough when they truly are. You will learn practical ways to establish breastfeeding in the first days and weeks, and find out how to increase your supply if you need to. We also dig into the evidence on galactagogues, the foods, herbs, and medications marketed to boost supply, so you know what the research really shows. Plus, we cover oversupply and the substances that can decrease how much milk you make.

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Breastfeeding Recommendations

Major health organizations largely agree on how long you should breastfeed. The World Health Organization, the American Academy of Pediatrics, and pediatric associations around the world recommend exclusive breastfeeding for about the first six months. After that, you introduce solid foods and continue breastfeeding for up to two years or beyond. Two years may sound like a long time, and it is worth saying clearly that any amount of time your baby receives breast milk is beneficial. In practice, far fewer mothers reach these goals. According to the most recent CDC data, about 85.7% started out breastfeeding, but only 27.9% were still exclusively breastfed at six months. That number keeps dropping as babies get older. The top reason mothers stop breastfeeding is a belief that they are not making enough milk.

How Common Is True Low Milk Supply?

Here is the reassuring part. True, physiological low milk supply is rare. The research shows that only about 5% of mothers experience actual milk insufficiency because of a pathological or anatomical reason. That means the vast majority of mothers can produce plenty of milk for their babies. However, that ability depends on establishing breastfeeding well, especially in the first month. When milk supply falls short, it is usually because milk was not removed frequently or effectively, not because a mother’s body cannot make enough. That is good news, because it means supply is something you can usually protect and build.

How Milk Production Works

During pregnancy, your body starts producing colostrum. This first milk is packed with immune factors, protein, sugar, and fats, along with agents that help seal, protect, and repair your baby’s intestines. Your baby’s stomach is tiny at birth. On the first day, they take in only about an ounce of colostrum spread across several feedings. Around day three or four, your milk comes in, and your baby gradually increases how much they drink over the first month. From roughly one to six months, the amount your baby consumes stays fairly consistent, right up until you start introducing solid foods.

The single most important principle to understand is this. The amount of milk your body makes depends on how much milk you remove. This is a supply-and-demand system. The more milk that leaves your breasts, the more your body produces. This principle is the cornerstone of breastfeeding, and nearly everything else in this episode builds on it.

Establishing Your Supply in the First Weeks

The first two to three weeks after birth are especially important for setting up a strong milk supply. Frequent nursing during this window signals your body to keep producing milk. The number one thing you can do is feed your baby often. Expect to breastfeed somewhere between 8 and 12 or more times in 24 hours. You cannot nurse too often, and frequent feedings are critical to building supply. You may also consider pumping, though a breast pump is generally not as efficient at removing milk as your baby.

Each breast makes milk based on how much is removed from that side. Because of that, you want to use both breasts throughout the day. You do not need to obsess over splitting time evenly between your left and right side. If one side is sore and needs a break, or your baby is ready to switch, you can always move to the other breast. The point is simply that you do not want to consistently favor one side over the other.

Your baby will go through growth spurts and cluster feed, nursing more often for a stretch of time. This is not a sign that your supply is failing. It is your baby placing an order for more milk, which tells your body to ramp up production to meet the new demand. This demand-and-supply loop is your first line of defense, and you can also use it purposefully to increase your supply.

Why Frequent Feeding Matters More Than Anything Else

When a mother worries her supply is low, she often starts supplementing with infant formula. That feels logical, but it can also work against you. If you replace a breastfeeding session with formula, your breasts remove less milk, so your body makes less milk.

Supplementing is not a problem if that is your goal, or if you are moving toward formula. Some mothers do need to supplement, especially if a baby is not getting enough milk, and that is a valid, sometimes necessary choice. But if your goal is to exclusively breastfeed or to increase your supply, unnecessary supplementing can derail your plans. When you are not sure, working with a lactation consultant can help you sort out what is actually happening and what to do about it.

How to Gauge Your Milk Supply

One of the trickiest parts of breastfeeding is that you cannot see how many ounces your baby is getting. That uncertainty is exactly what fuels supply worries. The good news is that you have reliable ways to check whether your baby is getting enough, and none of them require measuring ounces.

The best overall measure is your baby’s weight gain and diaper output. Your pediatrician will track weight at each visit. Babies naturally lose some weight after birth before they start gaining. In general, your pediatrician does not want to see a baby lose more than about 10% of their birth weight, and wants them back to birth weight within about two weeks.

One important caveat involves IV fluids during labor. IV fluids can leave your baby carrying extra fluid at birth, which they then shed in the days after. Your doctor may read that fluid loss as weight loss from not eating enough. This is very common in hospitals, especially with Pitocin or an epidural. In fact, one study found that newborns whose mothers received more fluid during labor lost significantly more weight in the first days, and that the extra loss reflected the baby flushing out fluid rather than not eating enough. So keep this in mind if you had IV fluids during your labor.

Diaper Output

What comes out is a great clue to what is going in. In the first 24 hours, you will mostly see meconium, which is thick, tar-like, and black. Over the next day or two, stools transition from that dark color toward green and then brown as your milk comes in. By around day five, stools typically turn yellow, which becomes the norm going forward. If you are formula feeding or combination feeding, yellow to tan or brown stools are also normal, though they tend to be a bit firmer than the stools of an exclusively breastfed baby.

Wet diapers are just as telling. According to La Leche League, by day two you are looking for at least two wet diapers over 24 hours. On days three and four, look for three or more. By five days old, you should see six or more wet diapers over 24 hours. Steady wet and dirty diapers, along with good weight gain, are strong signs your baby is getting enough.

Test Weighing

Another option is test weighing, where you weigh your baby right before and right after a feeding to estimate how much milk they took in. Research shows that test weighing can boost a mother’s breastfeeding confidence, which in turn shapes how she perceives her supply.

You may have access to an accurate scale at your pediatrician’s office or a breastfeeding support group. Most home scales are not precise enough for this, since you need one that reads in grams. There are scales you can buy for home use, but weighing before and after every feeding can add stress rather than relieve it. If you are considering it, talk to a lactation consultant first, so you use it in a way that is helpful rather than a source of anxiety.

When It Is Real Low Supply Versus Perceived Low Supply

There is an important difference between actually making too little milk and believing you are. Researchers call the second one perceived insufficient milk supply, and it drives a huge share of early weaning. If a mother thinks she is not producing enough, she will often supplement or switch to formula, even when her supply is fine. Keep in mind that until your baby’s first birthday, breast milk or formula is their primary source of nutrition, so if you cut back on feedings, you have to make up the difference with formula.

A systematic review and meta-analysis found that roughly 50% of mothers named perceived insufficient milk supply as their reason for stopping breastfeeding. Across studies from around the world, the incidence of perceived insufficient milk supply ranged from about 10% to 25%. That is a big gap when you take into account that only about 5% of mothers have a true physiological reason they cannot make enough.

So how do you tell the difference? Genuine low supply tends to show up as poor weight gain, too few wet and dirty diapers, or signs your baby is not satisfied after feeding despite frequent, effective nursing. A baby who is not getting enough may seem persistently fussy or unsettled right after a feed, stay latched for very long stretches without seeming content, or feed almost constantly yet never seem satisfied. If you see those signs, that is your cue to reach out to your pediatrician or a lactation consultant promptly.

On the other hand, if your baby is gaining well and filling diapers, your supply is very likely fine, even on days it does not feel that way. Remember that there will be times, especially during growth spurts, when your baby wants to eat far more often. With time, you will learn to recognize these spurts for what they are rather than reading them as a supply problem.

Building Your Breastfeeding Confidence

Your confidence plays a bigger role than you might expect. Studies show that several factors shape how you perceive your supply, and one of the biggest is breastfeeding self-efficacy. This is simply your confidence in your ability to feed your baby. In fact, you are seven times more likely to perceive insufficient milk supply if you lack breastfeeding knowledge. The best way to build that confidence is to educate yourself before your baby arrives.

There are excellent resources to help. You can browse all of the Pregnancy Podcast breastfeeding episodes and links to additional support in one place. The Womanly Art of Breastfeeding is a thorough book you can lean on as a reference throughout your journey. The Kelly Mom blog is another outstanding online resource, with detailed articles on nearly every question that comes up with nursing.

Set a Long-Term Breastfeeding Goal

Once you have the basics down, set a goal for how long you would like to breastfeed. Research shows that having a long-term breastfeeding plan is positively associated with breastfeeding self-efficacy. This goal is not set in stone. You can adjust it, extend it, or decide to stop or supplement whenever that is right for you and your baby. The point is that a plan gives you an anchor to return to when breastfeeding feels uncertain, or you run into issues.

Initiating Breastfeeding After Birth

How you start matters. Once your baby is born, you want to begin breastfeeding as soon as possible. You are four times more likely to perceive insufficient milk supply if you delay that first feeding. One of the best ways to get started is skin-to-skin contact right after birth. There is evidence that mothers who hold their newborns skin-to-skin show more confidence caring for their babies and breastfeed for longer.

Newborns are born with the instinct and motivation to breastfeed. When placed skin-to-skin, a healthy baby can actually find the breast and self-attach without much help. Researchers have documented nine observable behaviors that lead to that first feeding, a sequence known as the breast crawl. Usually all of this unfolds within the first hour after birth.

Breastfeeding Issues That Can Affect Supply

Breastfeeding takes practice and patience as you and your baby find your rhythm. Along the way, issues can come up that make it harder to remove milk, and anything that reduces milk removal can reduce your supply. Some problems show up in your breasts, like leaking, sore nipples, pain, vasospasms, blebs, plugged ducts, mastitis, and engorgement. Others involve your baby, such as jaundice, tongue-tie, thrush, food sensitivities, nursing strikes, and cluster feeding. A poor latch, tongue-tie, or lip-tie can make sucking inefficient, which limits how much milk actually leaves your breast.

The encouraging news is that these problems usually have solutions. There is an entire episode on troubleshooting common breastfeeding issues that walks through the most common symptoms and how to resolve them. It is a good starting point if something feels off, and a lactation consultant can help you pinpoint and fix an issue before it affects your supply.

Galactagogues and Lactogenic Foods

Galactagogues and lactogenic foods are substances thought to increase milk supply. Before we get into them, remember the order of operations. The first line of defense for making more milk is always frequent, effective milk removal. Medications, foods, and herbs are the second line of defense, and no supplement can make up for a lack of milk removal. With that framing in mind, let us look at what the evidence actually shows.

Pharmaceutical Galactagogues

There are prescription medications that doctors sometimes use to treat lactation insufficiency. These are prescribed off-label, meaning the drug was originally approved for another condition. As with any medication, efficacy, risks, and benefits vary. A great resource here is the LactMed database, where you can look up any medication and find detailed information on its safety during breastfeeding to make an informed decision.

An in-depth review examined the efficacy and safety of pharmaceutical galactagogues. Most of the studies focused on the two most commonly used options, domperidone and metoclopramide. These are both gut-motility drugs that happen to raise prolactin, the hormone behind milk production. Domperidone, sold under the brand name Motilium, is considered a first-line option, but the FDA has not approved it for use in the United States. The next option is metoclopramide, known by the brand name Reglan. It is available in the United States, but it carries a higher risk of side effects, and according to LactMed its clinical value for increasing milk supply is questionable.

The review also looked at less common options. Antipsychotics like sulpiride raise prolactin too, and have occasionally been used off-label for supply. This is typically not a viable choice because of their side effects, and this drug is also not approved in the United States. Evidence is limited for options like growth hormone, recombinant human prolactin, and thyrotropin-releasing hormone, and these remain largely research curiosities rather than treatments you would encounter in practice. A pilot study on metformin, which was investigated because insulin resistance and PCOS are linked to low supply, did not provide compelling evidence to support its use either. The bottom line is that there is no ideal drug for increasing milk supply, which brings us back to the natural remedies, foods, and herbs many mothers try instead.

Natural, Food, and Herbal Galactagogues

Many substances are thought to support milk supply, and some cultures have used them for centuries. An Australian study found that 60% of mothers used one or more galactagogues, most commonly lactation cookies (47%), brewer’s yeast (32%), and fenugreek (22%). Another study surveyed U.S. women who used galactagogues, and overall participants felt these helped increase their supply. That result may partly reflect a placebo effect, meaning mothers perceived more milk simply because they were taking something they believed would work.

Here is the challenge with the research. Studies on natural galactagogues tend to be small and use different methods to measure outcomes. When you look at the whole body of evidence, the results are mixed. A Cochrane review examined 27 studies comparing natural oral galactagogues with placebo or no treatment, including banana flower, fennel, fenugreek, ginger, ixbut, levant cotton, moringa, palm dates, pork knuckle, shatavari, silymarin, and torbangun leaves. For each one, the analysis showed either a possible benefit or little to no difference, all based on very low-certainty evidence.

A few specifics stood out. Moringa and mixed botanical tea may increase infant weight compared to placebo. The evidence on fennel and fenugreek was uncertain. Adverse effects were rarely reported, and where they were, they involved only minor complaints. On average, these studies included just 80 participants, which is why the authors concluded that high-quality randomized controlled trials on galactagogues are urgently needed.

Lactation cookies are a popular way to combine several of these ingredients. Common recipes include oats, brewer’s yeast, flaxseed, coconut oil, almond butter, and dates. The upside is that these may offer nutritional benefits like vitamins, minerals, iron, and healthy fats. The downside is that there is not solid evidence they increase supply. If you enjoy them and are not loading up on too much sugar, there is little downside to trying them.

Deciding Whether to Try Natural Galactagogues

When you weigh any intervention, you look at the risks and the benefits. With natural galactagogues, you may not have precise data on how well they work, but you can still weigh the possible upside against the risks. If you want to dig deeper into the potential effects of a specific herb, the LactMed database is an excellent resource. It includes a summary of use during lactation, how much of a substance transfers into your milk, effects on breastfed infants, and effects on your supply. Below are links to entries for some of the most common galactagogues.

• Anise
• Blessed Thistle
• Fennel
• Fenugreek
• Ginger
• Goat’s Rue
• Ixbut (Euphorbia lancifolia)
• Levant Cotton (Gossypium herbaceum)
• Milk Thistle
• Moringa
• Turmeric
• Torbangun (Coleus)
• Wild Asparagus (Shatavari)

Making Too Much Milk (Oversupply)

On the opposite end of the spectrum is oversupply. It may sound like a good problem to have, but it can create real challenges for both you and your baby. Oversupply can cause a forceful let-down that makes it hard for your baby to nurse comfortably, and it can leave your baby gulping, choking, or pulling off the breast. It can also contribute to engorgement, plugged ducts, and mastitis. Kelly Mom has an in-depth article on forceful let-down and oversupply if you want to go deeper.

Decreasing Your Milk Supply

Many mothers who experience oversupply notice it settle down by around three months. Reducing supply is a bit of a balancing act, because you do not want to overdo it and create the opposite problem. Kelly Mom has more information on using herbs to reduce your milk supply. A lactation consultant can be invaluable for managing oversupply without tipping into low supply.

Herbs That May Decrease Your Supply

Some herbs may lower your supply. If you want to dive into their potential effects, the LactMed database is again a great resource. Each entry covers use during lactation, transfer into milk, and effects on your baby and your supply. Below is a list from Kelly Mom of herbs to avoid, with links to the LactMed entry where one is available.

• Black Walnut
• Chickweed
• Herb Robert (Geranium robertianum)
• Lemon Balm
• Oregano
• Parsley (Petroselinum crispum)
• Peppermint (Mentha piperita)/Menthol
• Periwinkle Herb (Vinca minor)
• Sage (Salvia officinalis)
• Sorrel (Rumex acetosa)
• Spearmint
• Thyme
• Yarrow

The dose matters here. A dish seasoned with oregano is very unlikely to change your supply. You may just want to steer clear of something concentrated, like drinking oregano tea regularly.

Milk Removal Always Beats Supplements

If you take away one thing from this episode, it is that milk removal always beats supplements. No pharmaceutical or herbal supplement will make up for infrequent feedings. That said, if a supplement carries little or no risk and you are comfortable with it, there is often no harm in trying. Always run any supplement by your doctor or midwife first.

There are a lot of popular products on the market aimed at supply, from lactation cookies to teas, cookie mixes, and drink powders. Mother’s Milk Tea is one of the most common. It is an herbal tea that typically blends galactagogue ingredients like fenugreek, fennel, anise, blessed thistle, and coriander. The evidence that it meaningfully increases supply is thin, but it is low risk for most mothers. If you enjoy the taste and it does not cause any problems, there is no reason not to drink it. Worst case, you spent a little money on tea that helps you stay hydrated.

Talking to Your Doctor or Midwife

If your doctor, midwife, or pediatrician raises a concern that you may not be making enough milk, talk it through. Ask what is driving the concern and what you can do to improve how much you are producing or how much your baby is getting. If you want to keep breastfeeding, a lactation consultant is your best ally for resolving issues and increasing your supply.

I know that hiring a lactation consultant can sound expensive or out of reach, but a lot of this support is free or low cost. Your insurance may cover lactation visits, and many hospitals run free breastfeeding support groups. La Leche League is another excellent resource, a long-standing organization of trained breastfeeding leaders who offer help and answer questions at no cost, both in local meetings and online. You do not have to figure this out alone, and getting help early makes a real difference.

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