If you're breastfeeding and you feel like baby wants more than you have, or that you are simply not making enough milk, then as worrying as that often is, rest assured, you are not alone! Studies show that a fear that mothers' milk alone is not enough for her baby is the commonest reason for a mother stopping breastfeeding before she wanted or planned to, which is a shame.

Even more of a shame since there are often perfectly simple explanations for the signs that baby is not getting enough milk, which are easily dealt with by a mother with the right information and support - especially if that support is in the form of an experienced breastfeeding counsellor.

In truth, there are only a few reasons why a baby would not get enough milk from breastfeeding alone:

The first is that mum's milk hasn't fully come in, whether due to hormones or lack of them (sometimes caused by retained placenta or similar), and so if your baby is gaining weight, albeit a slowly, even if this is with a couple of oz formula supplementation per day, and is more than a few weeks old, then it's not that.

The second is that mum has had damage of some sort to her breasts / milk ducts, from scarring, perhaps from breast augmentation or reduction or other surgery, or from some infection, or more rarely from something like duct ecstasia.

The third is that milk came in fine but then something has happened physically to cause the milk production to not begin properly, or to be artificially halted, perhaps using hormonal contraceptives, or other pharmaceuticals, or becoming pregnant again, or extreme stress or anxiety.

Under this heading would also come physical changes to the body like certain illnesses or infections, or damage / blockages to the breast ducts perhaps even caused by bras or expressing.

Also under this heading would be barriers to milk production starting properly, such as retained placenta, a history of PCOS, thyroid problems, relatively recent surgery to her breasts, a diet which is deficient in some essential nutrient, for instance veganism and Vit B12/ iron, or anemia.

Some of these are discussed more fully in our article Boosting Supply

However by far the most likely is that the attachment at the breast is simply not enough to stimulate supply enough to satisfy babies' requirements - and of course adding formula, and bottles indeed, into the mix, are detrimental to the natural process of baby stimulating breastmilk to be produced. But that said, this writer does understand that many mothers feel so out of control and want to KNOW the baby is getting SOMETHING, and that it's not nice to feel like you're doing the wrong thing all the time. See our article on optimising positioning and attachment of baby, for help with this.

As for the small percentage of women who cannot BF, well in countries where BF is the norm - and we're talking western, industrialised countries like those in Scandinavia, where the population are not very different from our own - reports estimate that over 98% babies are BF for more than a couple of months. That doesn't mean 2% of women cannot breastfeed, that means that LESS than 2% AREN'T BF for whatever reason - could be the mum has a disease where something bad could be transmitted via the milk, could be she has had a mastectomy, or is taking a drug which is contraindicated during BF. Or it could be that she JUST DIDN'T FANCY IT!!

Have a look at our articles on boosting supply, but more importantly, have a look at the article about optimising baby's attachment to the breast so that your little one gets the best possible chance of stimulating your breasts to make more milk. And if you're giving formula in a bottle, which really isn't helping, perhaps this could be be replaced with expressed milk (EBM) - or formula if that's not possible - in eg a doidy cup, or even a syringe, if not a supplemetal nursing system ('SNS' - where baby suckles at the breast and is fed EBM / formula as they do so, via tiny capillary taped to the breast & nipple).

All these things are things that a proper qualified BF supporter should be able to give you more information about, and help you decide which way to go, so if you don't have access to one already, then CLICK HERE to find a counsellor locally.

In our experience, any problems with breastfeeding are almost always caused by, at least in part, a sub-optimal attachment - and so getting that cracked, and making sure baby feeds the 'right' way every time, is always the first target.