Reasons for low milk supply are well reviewed in the medical and research
literature.  A good review is:
Powers N:  Slow Weight Gain and Low Milk Supply in the Breastfeeding DYAD,
Clin in Perinatol 1999; 26(2):399-430.



I saw a  client recently who had a first child at age 40, a c-section with
unusually great blood loss, and was anemic to start with.  She needs iron
injections currently.  Her milk did not come in until late Day 6 (resulting
in 11% weight loss of a small-to-begin-with infant).  Her current average
milk production at a feeding (as carefully determined by serial wt. checks
on digital scale and by pumping of residual) is about 20-30 ml.  That is
around 1 oz.  Hopefully as her physical condition recovers she will have
energy to produce milk.



Early hypertension depresses and delays copious milk production.  Hormonal
imbalance (sometimes temporary -- due to gestational ovarian theca lutein
cysts or to thyroid problems) can cause low milk supply.  PCOS and thyroid
disease can sometimes cause abnormal adolescent breast development and
subsequent problems making adequate milk.  Breast surgery of any kind
increases the risk of milk production problems.



Poor early management of engorgement, over-scheduling of early feeds, time
limitations, etc. can rapidly and sometimes permanantly (for that lactation)
down-regulate production.



Maternal illness is a classic reason for low supply.



Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com
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