Initial presentation: The client, a 36-year-old first-time mother presents with low breast milk supply. She is 7 weeks postpartum and reports noticing a drop in breast fullness and milk supply around 3 weeks postpartum. She is feeding every 2–3 hours, noting the baby becomes fussy after 10 minutes of feeding and has started to question whether she needs to supplement with formula. She denies nipple pain or latch issues but admits to feeling stressed, overwhelmed and tired.
Her food intake is inconsistent due to baby demands, often relying on high-energy snacks and coffee to compensate for her fatigue. She drinks 1.5L of water daily and experiences fragmented sleep, estimating 3-4 hours total each night.
Vitals are stable and the client is generally healthy. No signs of mastitis or blocked breasts were reported during the physical exam. No thyroid issues were previously diagnosed. No known allergies and no current medications except an over-the-counter postnatal multivitamin.
Naturopathic assessment: 36-year-old breastfeeding mother presents with low breast milk supply, high stress and poor sleep, likely caused by inadequate nutrient intake, dehydration and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Exacerbated by the demands of newfound parenthood.
Key factors considered:
Nervous system dysregulation: Feelings of stress and overwhelm contribute to poor milk supply. Lack of sleep encourages reliance on high-energy snacks and coffee to compensate for fatigue.
Irregular meals and high caffeine intake: There is insufficient food intake to support the nutritional demands of breastfeeding.
Inadequate hydration: Appropriate fluid intake is essential for consistent and adequate milk supply.
Herbal medicine:
Fenugreek (Trigonella foenum-graecum): A popular herb indicated for low breast milk supply. Works to increase milk production by stimulating prolactin and oxytocin release.
Fennel (Foeniculum vulgare): Traditionally used to support lactation and increase milk supply.
Passionflower (Passiflora incarnata): Calms and soothes the nervous system, providing relief from feelings of overwhelm and mild anxiety. The sedative action of passionflower allows for enhanced sleep quality.
Withania (Withania somnifera): A tonic for the nervous system, Withania eases stress and overwhelm by regulating the release of our primary stress hormone, cortisol. Withania helps to alleviate fatigue by supporting the adrenal glands.
Herbal formula 200ml:
Fenugreek (Trigonella foenum-graecum) 1:2 - 80ml
Fennel (Foeniculum vulgare) 1:2 - 40ml
Passionflower (Passiflora incarnata) 1:2 - 60ml
Withania (Withania somnifera) 3:2 - 20ml
Dosage: 7.5mls twice daily.
Additional recommendations
Dietary modifications:
Increase fluid intake: Breast milk is approximately 87% water. Aim for 3.5L of water daily to support consistent milk supply and prevent dehydration. Additions such as citrus fruits, berries and cucumber are great ways to increase water consumption by adding natural flavour.
Eat three meals and two snacks daily: Lactation is a period of high-energy output, with energy needs increasing by 500 calories daily. Ensuring 3 meals daily, balanced with carbohydrates, fats, protein and fibre allows for balanced energy levels throughout the day, negating the need for caffeine dependance and reliance on high-energy snacks. Adequate daily food intake supports breast milk production and plays a critical role in mood stabilisation. Considering a meal subscription service could be an excellent way to ensure this client meets their nutritional requirements without having to allocate significant amounts of time for cooking. Adding lactogenic foods, such as oats, brewer's yeast, flaxseeds and almonds to easy meals such as smoothies is an excellent way to increase milk production.
Reduce caffeine intake: Too much caffeine can be dehydrating due to its diuretic action. Switching out cups of coffee for lactation and nervous system friendly herbal teas such as fennel, fenugreek, nettle and lemon balm is a great way to encourage breast milk production and supply, while nourishing the nervous system.
Lifestyle modifications:
Implement relaxation techniques into daily life: Relaxation techniques such as mindfulness meditation, breathwork and listening to calming nature sounds work to stimulate oxytocin release. Oxytocin stimulates the parasympathetic or “rest and digest” branch of the nervous system, resulting in lowered stress levels and feelings of calm and relaxation. Nervous system support is conducive to increased milk production, volume and infant feeding through the release of oxytocin.
Sleep hygiene: A consistent sleep hygiene routine can be highly beneficial for a breastfeeding mother, as adequate and quality rest supports hormone regulation; particularly prolactin, the hormone essential for milk production. Poor sleep can lead to stress and fatigue, both of which have been shown to negatively impact milk supply. By establishing calming bedtime habits like limiting screen time, creating a quiet sleep environment, and maintaining a regular sleep schedule, sleep quality can be improved.
Aim to do physical movement outside 3x weekly: Exposure to natural light helps regulate the body’s circadian rhythm, promoting better sleep quality and more consistent sleep-wake patterns. Improved sleep also supports the hormonal balance required for lactation, particularly the production of prolactin and oxytocin, which are vital for consistent milk supply. Additionally, gentle physical activity such as walking, can reduce stress and improve overall mood; factors known to positively influence breastfeeding by lowering cortisol levels, which can otherwise inhibit milk production.
Follow up: After 4 weeks of following the wellness plan, the client reported a noticeable increase in her milk supply and volume. She noted increased breast fullness before feeds and observed that her baby appeared more content and less fussy following breastfeeding sessions. Her energy levels are consistent and balanced throughout the day with regular meals and snacks, reducing reliance on caffeine and high-energy snacks to get her through the day. While she continues to experience periodic stress and fatigue, these feelings are now significantly less overwhelming and are more manageable.