You might be surprised by what can affect your breastfeeding journey

If you plan to breastfeed your baby, you’re probably registering for the best accessories, stocking up on nursing bras, and reading up on how to build and maintain a good milk supply. While most moms can produce enough milk for their babies through frequent, on-demand feedings, some surprising factors can affect your milk supply, and, in turn, breastfeeding your newborn. Not to worry—with a little info and lots of support, you’ll be well-informed and prepared for any potential challenges. Here are seven factors that can impact your milk production:

1. Breast Reduction

While breastfeeding after a breast reduction can be difficult, it’s not impossible. During a breast reduction surgery, the surgeon may remove part of the tissue and ducts that produce milk, as well as affect some of the nerves responsible for letdown, the reflex that triggers milk to be expelled. Most of the time, the surgeon will leave the nipple and cut around it, giving a greater chance for the nerves to regain some or all sensation in about a year’s time. But in cases where the nipple is removed and reattached, it can prevent the ability to breastfeed. La Leche League reports that women produce a better milk supply if surgery occurs five or more years before pregnancy. Consult your physician for information on your surgery and its potential impact on breastfeeding.

Unfortunately, it’s hard to know how surgery will impact your supply until your baby is born. Be prepared to supplement with formula if needed, use a pump or supplemental nursing system to further stimulate your milk production. Reach out to an IBCLC for help building your supply immediately after delivery.

2. Breast Implants

It’s possible to breastfeed after breast augmentation surgery. Breast implants placed below the muscle usually have less of an effect on milk production than implants placed above the muscle. As with breast reduction surgery, the impact on your milk supply will depend on how the milk ducts and nerves were affected, whether the nipple was removed and whether these parts regained functionality and sensation.

Prior to surgery, some women may have mammary hypoplasia, or insufficient glandular tissue, which can cause breasts to appear tubular, asymmetrical or wide-set, and lead women to choose breast reconstructive surgery. It can also cause insufficient milk production. For some moms who’ve had surgery, mammary hypoplasia may actually be the primary reason they need to supplement. It’s always a good idea to talk to your doctor about your individual medical history and its implications.

3. Breast Cancer

If you’ve undergone treatment for breast cancer, such as surgery or radiation, it may have an impact on your ability to breastfeed. Many women are still able to breastfeed, but depending on the type of treatment, your milk supply may be lower or you may experience structural changes that make it painful to breastfeed or difficult for your baby to latch. If you’re on medication to treat breast cancer, be sure to consult your doctor. Some drugs can enter breast milk and be passed on to your baby, as well as affect your milk supply.

4. Postpartum Hemorrhage

Experiencing a traumatic birth may affect when your milk comes in and how much your body produces. Between the physical stress on your body and separation from your baby after birth, postpartum hemorrhage can contribute to potential difficulties building milk supply. But that doesn’t mean your supply can’t bounce back. Once you’ve recovered, begin nursing frequently, as well as pumping to further increase milk production if needed. Work closely with your health care provider and an IBCLC in those first days after delivery.

5. Hypothyroidism

The thyroid helps regulate prolactin and oxytocin, two important hormones in milk production. There hasn’t been much research specifically on the thyroid and its impact on milk supply, but if you experience issues with milk supply, low thyroid hormone levels could be to blame. Other symptoms of hypothyroidism include weight gain, dry skin, thinning hair, poor appetite, fatigue and depression. If you’re experiencing any of these symptoms, talk to your doctor about potential thyroid issues.

6. Work and Stress

Stress won’t completely halt your milk production, but it can negatively impact it. Some research has found that stress can cause a decrease in the release of oxytocin, a crucial hormone in milk production, into the bloodstream. But there’s good news: Oxytocin also has a relaxing effect, so moms may find that breastfeeding helps bring them a sense of calm in stressful times.

For working moms, the stress of returning to their jobs can be an issue. Going back to work also presents the need for frequent pumping breaks, and when a mom doesn’t or can’t fit in those pumping sessions, it signals to her body that it doesn’t need to produce as much milk, causing a hit to her supply. And finally, in stressful periods, moms often skip crucial self-care, like adequate sleep and good nutrition, which are so important for supporting her physical and mental health and milk production.

7. Medications and Supplements

When you’re breastfeeding, it’s a good idea to take a close look at everything you put into your body. While many medications and supplements may be considered safe for breastfeeding, they can negatively affect your milk supply. For example, decongestants, such as pseudoephedrine and phenylephedrine, that are often found in allergy and cold medications work by constricting the blood vessels in the nose and sinuses, helping to open up the nasal passage. But that means they can also reduce the blood flow in the breasts that is necessary for milk production.

Some prescription medications (such as birth control that contains estrogen), herbs and essential oils can also lower milk supply. Even certain galactogogues—herbal supplements like fenugreek that are used to create or boost milk supply—can produce the opposite effect in some moms. Discuss any medications or supplements with your physician and be sure to communicate the importance of maintaining your milk supply.

So many moms worry about producing a sufficient milk supply (so know that you’re not alone!). Whether you’re able to exclusively breastfeed, need to supplement or can breastfeed for only a short time, you’re helping your baby grow and thrive. If you have questions or concerns about breastfeeding, reach out to our team at Ashland Women’s Health, which is run by moms for moms. We’ll connect you to The Lactation Network who are there to support you every step of the way.