Do I Actually Have a Low Milk Supply? How to Tell the Difference Between Normal Breastfeeding and Real Red Flags

"I don't think I'm making enough milk."

Unlike bottle feeding, when you're breastfeeding, you can't see how many ounces your baby is taking. So when your newborn wants to nurse again an hour later, seems fussy after a feeding, or your breasts suddenly stop feeling full, it's easy to start having concerns about your milk supply.

The good news is that many of the things parents interpret as low milk supply are actually completely normal newborn behavior.

That doesn't mean low milk supply never happens, it absolutely can and does. But before you panic, it's important to know what actually tells us your baby is getting enough milk.

What Does a Normal Milk Supply Look Like?

In the first few hours and days following birth, your body makes just a few ounces per day of colostrum, often fondly referred to as "liquid gold." This is your first milk - and it's actually there after just about 16-22 weeks of pregnancy, meaning you have milk as soon as you give birth. A few teaspoons at a time may seem like too small of an amount, but your baby's belly is so tiny, colostrum is the perfect volume to meet their needs in just a few milliliters or teaspoons per feed.

The misconception that colostrum is not enough for your baby can be one of the first times where parents struggle to understand or trust their milk supply. This is often a time where supplementation with formula or donor milk is introduced, sometimes leading to less milk removal and stimulation of the breast, therefore leading to actual decreased supply. Of course, there are many reasons babies do need supplementation in the early days, but this should be coupled with lactation support. Work with your individual provider and never be afraid to include a lactation consultant.

Around 2--5 days postpartum, your breasts may suddenly feel much fuller, heavier, or even swollen as milk volume rapidly increases. This is the stage most people describe as their milk "coming in," and is referring to colostrum changing to transitional and eventually mature milk, which is higher in volume. But remember - you have milk before this happens, because colostrum is milk!

After this transition from colostrum to transitional milk, you will start to make "mature" milk by around weeks 2-4 postpartum. At this point, a "full" milk supply consists of producing about 25--35 ounces of milk every 24 hours, or roughly 1--1¼ ounces per hour. There is certainly variability to this, but this is a general average.

The challenge is that you can't see those ounces while nursing, so how do we know you're making that milk?

Well, we look at your baby and your breasts!

Five Green Flags That Breastfeeding Is Going Well

1. Your baby is actively sucking and swallowing.

The length of a feeding doesn't tell us much by itself.

Instead, pay attention to how your baby feeds.

At some point during the feeding, you should notice slower, deeper sucks with visible or audible swallowing. Babies often begin and end a feeding with quick flutter sucks, but the middle of the feeding is where you'll typically hear swallowing and see effective milk transfer.

2. Your breasts feel softer afterward.

Your breasts are never completely empty, but after an effective feeding they should generally feel softer than they did before your baby nursed.

3. Your baby seems satisfied.

Many babies relax after feeding.

You might notice:

soft, open hands instead of tightly clenched fists
relaxed body language
milk around the mouth after unlatching

Not every baby falls asleep after every feeding, but contentment is another reassuring sign as long as they have been actively feeding, are gaining weight, and are making adequate wet and dirty diapers.

4. Diaper output is where it should be.

This is one of the most reliable indicators of milk intake. Babies are expected to have one wet (pee) diaper per day of life through the first 6 days (so 1 pee on day 1, 2 pees on day 2 and so forth) and 4 stools per day by day of life 4. After the first week of life, breastfed babies should typically continue to have:

At least 6-8 wet diapers per day
At least 1-4 yellow, seedy stools daily (ideally 4+)

If your baby is also receiving formula, stool color and frequency may look a little different (typically thicker, more brownish-green, and less frequent).

5. Your baby is gaining weight.

In addition to diaper output, weight gain is one of the most reliable indicators of adequate milk intake.

It's normal for newborns to lose some weight after birth, but most babies should:

lose no more than 7--10% of birth weight
stop losing weight by around day 3
regain birth weight by 7--14 days of life
gain about 1 ounce (30 grams) per day during the first several months

Remember these "green flags" when you are feeling uncertain about your milk supply.

Things That Might Feel Like Low Milk Supply but are Often Normal

Those long newborn nights when you're awake and scrolling can lead to questioning your milk supply. Maybe you see someone else's baby is sleeping longer stretches, or someone else is pumping 100 oz of milk per day. You start to wonder if you're doing something wrong or if you're missing something.

This is where learning many of the "normal" newborn patterns and temperaments can be so reassuring.

Frequent feeding

Newborns typically nurse and should feed at least 8--12 or more times every 24 hours, and many eat every 1--2 hours during the early weeks. Cluster feeding - when babies seem to want to nurse constantly for several hours - is also completely normal. Rather than indicating low supply, it's one of the ways babies naturally help increase milk production.

Night waking

Newborns and young babies are supposed to wake throughout the night to feed. Those nighttime feedings are important not only for your baby's growth and safety, but also for establishing and maintaining your milk supply. By leaning into your baby's natural feeding inclinations, you are also supporting your milk supply, because your body is dependent on overnight milk removal to maintain a robust supply.

Your breasts don't feel as full anymore

Softer breasts, less leaking, and no longer feeling engorged after the first month or so are typically normal changes as long as your baby continues growing well and showing signs of milk transfer (those "green flags" we talked about before). Your body and hormones are learning what your baby needs, and residual swelling from engorgement decreases as your body adapts to the breasts being full of milk.

You don't have a freezer full of milk

Social media has convinced many parents that success equals hundreds of ounces stored in a deep freezer - but you do not need a freezer full of milk to be able to feed your baby, and frozen milk is not a measure of a full milk supply. Your body is designed to make the milk your baby needs, not necessarily large amounts of extra milk.

Your baby will still take a bottle

Sucking is soothing for baby, but it's also reflexive, meaning young babies will almost always suck on a bottle or pacifier even if they are full. That means that even if they're satisfied from the breast, if offered a bottle, they'll often still take it. This is sometimes called the "top-up trap," and it can make parents believe supplementation is necessary even when breastfeeding is going well. More supplementation = less effective breast stimulation when baby does feed, which actually can lead to low milk supply.

When Should You Be Concerned?

While many supply concerns are based on normal newborn behavior, there are situations that deserve further evaluation.

Reach out to your baby's healthcare provider and an IBCLC if:

your milk hasn't transitioned from colostrum by 5--7 days postpartum
your baby loses more than 10% of birth weight
your baby hasn't regained birth weight by 10--14 days
diaper output is lower than expected
weight gain slows or falls off the growth curve
your baby consistently falls asleep after only a few minutes of nursing
you rarely hear swallowing
breastfeeding is persistently painful
your baby can't maintain a seal at the breast (clicking or leaking milk)
feeds consistently last longer than 30--45 minutes after the early weeks without signs of efficient feeding
your baby develops persistent jaundice or signs of dehydration

What If You Really Do Have Low Milk Supply?

Sometimes a medical condition limits milk production (called primary low milk supply), but this is much less common. More often, parents experience secondary low milk supply, which develops when milk isn't removed frequently or effectively enough.

Common causes of primary low milk supply can include: thyroid disorders, PCOS, diabetes, insufficient glandular tissue/breast development, prior breast surgeries, significant postpartum hemorrhage, or retained placenta. Having one or more of these conditions means there is a risk of low supply, not a guarantee. Working with an IBCLC to monitor and make a plan can help you make the most milk possible, and you can often still have a full milk supply.

Secondary low milk supply, or low supply that develops secondary to ineffective or infrequent milk removal, is much more common, and often something we can improve.

One of the most common and preventable causes of secondary low milk supply begins with perceived low supply.

Remember the top-up trap? Here it is in action:

A baby cluster feeds.

Parents worry baby isn't getting enough.

Formula is offered after every nursing session.

The baby nurses less.

The breasts receive less stimulation.

The body responds by making less milk.

In other words:

Perceived low milk supply can unintentionally become actual low milk supply if milk removal decreases.

That doesn't mean supplementation is wrong - supplementation is sometimes absolutely necessary.

Supplementation isn't the problem. Supplementation without a lactation plan is.

If your baby needs additional milk, your breasts may also need additional stimulation through nursing, pumping, or hand expression to protect your milk supply while you address the underlying issue. And sometimes, we can provide your baby with additional milk from you with extra stimulation (AKA feeding pumped/expressed milk) and getting to the root cause of why supplementation is necessary in the first place.

The Bottom Line

Learning about how your milk supply works can make you more confident when you're wondering if what your baby is doing is "normal" or if you should be concerned about your milk supply. Remember that there are reliable ways to know if baby is transferring milk and getting what they need even if we can't see the ounces they are taking. Do your breasts feel softer after feeding? Is baby actively feeding, making plenty of wet and dirty diapers, and gaining adequate weight?

If something doesn't feel right, you don't have to figure it out on your own! Reach out to an IBCLC for an evaluation and ensure you and baby are set up for long-term success.

Do I Actually Have a Low Milk Supply?