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PBL Foundations


  • Encouraging baby to 'drain' your breast doesn't increase baby's fat intake and can worsen breastfeeding problems
  • Things that AREN'T signs of low milk supply (despite what you might have heard)
  • What DOESN'T help you and your breastfeeding support professionals work out if you have enough milk
  • What DOESN'T help with low supply: taking oxytocin, iron infusions, diet, or drinking more water

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  • PBL Foundations
  • S9: Making the right amount of breast milk
  • CH 2: When you don't have enough milk
  • PT 2.4: Busting myths about low supply

What DOESN'T help you and your breastfeeding support professionals work out if you have enough milk

Dr Pamela Douglas19th of Oct 202428th of Mar 2025

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The amount of tightness or fullness of your breasts doesn't help you work out if you have enough milk

It's true that studies of women who pump their breastmilk have shown that more milk can be removed from a breast that feels full prior to pumping.

However, waiting for your breasts to feel full before breastfeeding may cause your supply to drop off. This is because high pressures inside the milk glands send messages which cause the breasts to produce less milk. You can find out about this here.

Tightness or fullness of your breast is not a good indicator of how much milk you're producing.

After about six weeks of breastfeeding, many women find that their breasts are mostly not particularly tight. This is because they are offering their breasts to their baby frequently and flexibly, and their milk supply has calibrated to meet their baby's need. Any overshoot of milk production volume has been downregulated.

Counting milk ejections doesn't help you work out if you have enough milk

Most women won’t be aware of most of all of their milk ejections, and baby’s swallowing will be variable because many milk ejections don’t release large volumes of milk.

  • You can find out about your letdowns here.

  • You can find stories about letdown worries here and here.

Test weighing in a consultation doesn't help your breastfeeding support professional work out if you have enough milk

A breastfeeding support professional performs a test weigh by taking your baby's weight fully clothed before a breastfeed, and then again immediately after the breastfeed.

However, the amount of a milk a baby transfers in any one breastfeed is highly variable. Some breastfeeds don't involve much milk transfer at all in exclusively breastfed babies gaining weight beautifully. Test weighing before and after a single feed is unhelpful and may be misleading, for this reason.

Test weighing before and after feeds over a 24-hour period is a useful research tool, giving us one 24-hour milk intake volume. (There's every reason to think this may vary somewhat day to day, but it is more useful than a single test weigh.) However, test weighing at home can be disruptive to baby (waking baby up after a breastfeed, and causing baby to dial up a lot before a breastfeed). It also requires the primary carer to spend the day at home, which may cause baby to dial up and result in a stressful day.

I don’t recommend test weighing, because in my experience there are other more effective ways to work with weight gain challenges.

Counting suck-swallow ratios in a consultation doesn't help your breastfeeding support professional work out if you have enough milk

The research shows that suck-swallow ratios are highly variable in normal babies gaining weight well. Also, even when things are going well, some breastfeeds don't involve much milk transfer, and this may be the case during a consultation.

Placing pressure on any feed to be a 'meal' can cause breastfeeding to fail. You can find out about frequent and flexible breastfeeding here.

Using a stethescope in a consultation doesn't help your breastfeeding support professional work out if you have enough milk

Your breastfeeding support professional doesn't need a stethoscope to listen to baby's sucking. Noticing how much or how little swallowing and milk transfer is occuring requires listening for the 'k' sound of a swallow, and observing jaw movements, without a stethescope.

Milk transfer is variable between breastfeeds, and some breastfeeds don't involve much milk transfer at all. What matters for you and your baby is the pattern of milk transfer occuring over a 24-hour period. Your health professional's assessment of milk transfer will include multiple factors, such as urinary and stool output, the baby’s satiated or dialled up behaviour, the plot of the percentile chart, and weight relative to a previous weight.

You can find out how to know if your baby is receiving enough milk here.

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Next up in Busting myths about low supply

What DOESN'T help with low supply: taking oxytocin, iron infusions, diet, or drinking more water

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Is there a role for oxytocin when your supply is low?

You might be advised to try oxytocin because your letdown is poor.

I wish there was a quick fix which happened with using oxytocin preparations, but I’m afraid there isn’t. There is no evidence to suggest that synthetic oxytocin, which is available as a nasal spray, improves overall milk production, milk transfer, or baby’s weight gain.

  • Firstly, a woman's letdown is a remarkably resilience neurological reflex which isn't easily disrupted, including by stress (despite what you might hear).

  • Secondly, synthetic oxytocin is quickly associated with a Keep reading

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Possums acknowledges the traditional owners of the lands upon which The Possums Programs have been created, the Yuggera and Turrbal Peoples. We acknowledge that First Nations have breastfed, slept with, and lovingly raised their children on Australian lands for at least 65,000 years, to become the oldest continuous living culture on Earth. Possums stands with the Uluru Statement from the Heart.