Most mothers can make plenty of milk for their babies. But many mothers are concerned about having enough.

Checking your baby’s weight and growth is the best way to make sure he or she is getting enough milk. Let the doctor know if you are concerned. For more ways to tell if your baby is getting enough milk, visit the How to know your baby is getting enough milksection.

There may be times when you think your supply is low, but it is actually just fine:

• When your baby is around 6 weeks to 2 months old, your breasts may no longer feel full. This is normal. At the same time, your baby may nurse for only five minutes at a time. This can mean that you and baby are just adjusting to the breastfeeding process — and getting good at it!
• Growth spurts can cause your baby to want to nurse longer and more often. These growth spurts can happen around 2 to 3 weeks, 6 weeks, and 3 months of age. They can also happen at any time. Don’t be alarmed that your supply is too low to satisfy your baby. Follow your baby’s lead — nursing more and more often will help build up your milk supply. Once your supply increases, you will likely be back to your usual routine.

What you can do

1. Make sure your baby is latched on and positioned well.
2. Breastfeed often and let your baby decide when to end the feeding.
3. Offer both breasts at each feeding. Have your baby stay at the first breast as long as he or she is still sucking and swallowing. Offer the second breast when the baby slows down or stops.
4. Try to avoid giving your baby formula or cereal as it may lead to less interest in breast milk. This will decrease your milk supply. Your baby doesn’t need solid foods until he or she is at least 6 months old. If you need to supplement the baby’s feedings, try using a spoon, cup, or a dropper.
5. Limit or stop pacifier use while trying the above tips at the same time.

Oversupply of milk

Some mothers are concerned about having an oversupply of milk. Having an overfull breast can make feedings stressful and uncomfortable for both mother and baby.

What you can do

1. Breastfeed on one side for each feeding. Continue to offer that same side for at least two hours until the next full feeding, gradually increasing the length of time per feeding.
2. If the other breast feels unbearably full before you are ready to breastfeed on it, hand express for a few moments to relieve some of the pressure. You can also use a cold compress or washcloth to reduce discomfort and swelling.
3. Feed your baby before he or she becomes overly hungry to prevent aggressive sucking. (Learn about hunger signs in the Tips for making it work section.)
4. Try positions that don’t allow the force of gravity to help as much with milk ejection, such as the side-lying position or the football hold. (See the Breastfeeding holds section for illustrations of these positions.)
5. Burp your baby frequently if he or she is gassy.

Some women have a strong milk ejection reflex or let-down. This can happen along with an oversupply of milk. If you have a rush of milk, try the following:

1. Hold your nipple between your forefinger and middle finger or with the side of your hand to lightly compress milk ducts to reduce the force of the milk ejection.
2. If baby chokes or sputters, unlatch him or her and let the excess milk spray into a towel or cloth.
3. Allow your baby to come on and off the breast at will.

Engorgement

It is normal for your breasts to become larger, heavier, and a little tender when they begin making more milk. Sometimes this fullness may turn into engorgement, when your breasts feel very hard and painful. You also may have breast swelling, tenderness, warmth, redness, throbbing, and flattening of the nipple. Engorgement sometimes also causes a low-grade fever and can be confused with a breast infection. Engorgement is the result of the milk building up. It usually happens during the third to fifth day after birth, but it can happen at any time.

Engorgement can lead to plugged ducts or a breast infection, so it is important to try to prevent it before this happens. If treated properly, engorgement should resolve.

What you can do

1. Breastfeed often after birth, allowing the baby to feed as long as he or she likes, as long as he or she is latched on well and sucking effectively. In the early weeks after birth, you should wake your baby to feed if four hours have passed since the beginning of the last feeding.
2. Work with a lactation consultant to improve the baby’s latch.
3. Breastfeed often on the affected side to remove the milk, keep it moving freely, and prevent the breast from becoming overly full.
4. Avoid overusing pacifiers and using bottles to supplement feedings.
5. Hand express or pump a little milk to first soften the breast, areola, and nipple before breastfeeding.
6. Massage the breast.
7. Use cold compresses in between feedings to help ease pain.
8. If you are returning to work, try to pump your milk on the same schedule that the baby breastfed at home. Or, you can pump at least every four hours.
9. Get enough rest, proper nutrition, and fluids.
10. Wear a well-fitting, supportive bra that is not too tight.

Plugged ducts

It is common for many women to have a plugged duct at some point breastfeeding. A plugged milk duct feels like a tender and sore lump in the breast. It is not accompanied by a fever or other symptoms. It happens when a milk duct does not properly drain and becomes inflamed. Then, pressure builds up behind the plug, and surrounding tissue becomes inflamed. A plugged duct usually only occurs in one breast at a time.

What you can do

1. Breastfeed often on the affected side, as often as every two hours. This helps loosen the plug, and keeps the milk moving freely.
2. Massage the area, starting behind the sore spot. Use your fingers in a circular motion and massage toward the nipple.
3. Use a warm compress on the sore area.
4. Get extra sleep or relax with your feet up to help speed healing. Often a plugged duct is the first sign that a mother is doing too much.
5. Wear a well-fitting supportive bra that is not too tight, since this can constrict milk ducts. Consider trying a bra without underwire.

Breast infection (mastitis)

Ask your doctor for help if you do not feel better within 24 hours of trying these tips, if you have a fever, or if your symptoms worsen. You might need medicine. See your doctor right away if:

• You have a breast infection in which both breasts look affected
• There is pus or blood in the milk
• You have red streaks near the area
• Your symptoms came on severely and suddenly

Even if you are taking medicine, continue to breastfeed during treatment. This is best for both you and your baby. Ask a lactation consultant for help if needed.
Mastitis (mast-EYE-tiss) is soreness or a lump in the breast that can be accompanied by a fever and/or flu-like symptoms, such as feeling run down or very achy. Some women with a breast infection also have nausea and vomiting. You also may have yellowish discharge from the nipple that looks like colostrum. Or, the breasts may feel warm or hot to the touch and appear pink or red. A breast infection can occur when other family members have a cold or the flu. It usually only occurs in one breast. It is not always easy to tell the difference between a breast infection and a plugged duct because both have similar symptoms and can improve within 24 to 48 hours. Most breast infections that do not improve on their own within this time period need to be treated with medicine given by a doctor. (Learn more about medicines and breastfeeding in our Breastfeeding fact sheet.)

What you can do

1. Breastfeed often on the affected side, as often as every two hours. This keeps the milk moving freely, and keeps the breast from becoming overly full.
2. Massage the area, starting behind the sore spot. Use your fingers in a circular motion and massage toward the nipple.
3. Apply heat to the sore area with a warm compress.
4. Get extra sleep or relax with your feet up to help speed healing. Often a breast infection is the first sign that a mother is doing too much and becoming overly tired.
5. Wear a well-fitting supportive bra that is not too tight, since this can constrict milk ducts.

Fungal infections

A fungal infection, also called a yeast infection or thrush, can form on your nipples or in your breast because it thrives on milk. The infection forms from an overgrowth of the Candida organism. Candida exists in our bodies and is kept at healthy levels by the natural bacteria in our bodies. When the natural balance of bacteria is upset, Candida can overgrow, causing an infection.

If you or your baby has symptoms of a fungal infection, call both your doctor and your baby’s doctor so you can be correctly diagnosed and treated at the same time. This will help prevent passing the infection to each other.

A key sign of a fungal infection is if you develop sore nipples that last more than a few days, even after you make sure your baby has a good latch. Or, you may suddenly get sore nipples after several weeks of pain-free breastfeeding. Some other signs of a fungal infection include pink, flaky, shiny, itchy or cracked nipples, or deep pink and blistered nipples. You also could have achy breasts or shooting pains deep in the breast during or after feedings.

Causes of thrush include:

• Thrush in your baby’s mouth, which can pass to you
• An overly moist environment on your skin or nipples that are sore or cracked
• Antibiotics or steroids
• A chronic illness like HIV, diabetes, or anemia

Thrush in a baby’s mouth appears as little white spots on the inside of the cheeks, gums, or tongue. Many babies with thrush refuse to nurse, or are gassy or cranky. A baby’s fungal infection can also appear as a diaper rash that looks like small red dots around a main rash. This rash will not go away by using regular diaper rash creams.

What you can doFungal infections may take several weeks to cure, so it is important to follow these tips to avoid spreading the infection:

1. Change disposable nursing pads often.
2. Wash any towels or clothing that comes in contact with the yeast in very hot water (above 122°F).
3. Wear a clean bra every day.
4. Wash your hands often, and wash your baby’s hands often — especially if he or she sucks on his or her fingers.
5. Put pacifiers, bottle nipples, or toys your baby puts in his or her mouth in a pot of water and bring it to a roaring boil daily. After one week of treatment, discard pacifiers and nipples and buy new ones.
6. Boil daily all breast pump parts that touch the milk.
7. Make sure other family members are free of thrush or other fungal infections. If they have symptoms, make sure they get treated.