Overview of postpartum lactation promotion

Breastfeeding has beneficial effects for both the infant (eg improved immunocompetence, enhanced cognitive development) and parent (eg enhanced parental–infant attachment, better uterine involution, decreased risk of breast and ovarian cancers). Therefore, exclusive breastfeeding is advised for the first 6 months of life, if possible.

Low supply of breast milk leads to early cessation of breastfeeding. The most common cause is insufficient removal of milk from the breasts, which can occur due to poor attachment of the infant, insufficient feeding or expressing, breast engorgement, inverted nipples, prematurity or oral cavity abnormalities in the infant, such as tongue tie.

Other causes of low supply include hypoplastic breasts, breast surgery, hypothyroidism, anaemia, diabetes, obesity, cigarette smoking, or alcohol consumption, but it may also be idiopathic.

Low supply of breast milk may be indicated by the breasts remaining soft between feeds, or by the infant being unsettled shortly after feeds or persistently sleepy, or having fewer wet nappies, concentrated urine, persistent jaundice, poor weight gain or weight loss greater than 10% of birth weight.

Patient information on breastfeeding is available from the Australian Breastfeeding Association and the Royal Women’s Hospital website.

Some individuals seeking lactation promotion may not identify as cis women; for links to resources to support gender-inclusive healthcare, see Trans and gender diverse healthcare. Advice in this breastfeeding topic does not apply to individuals who have had gender-affirming hormone therapy or gender-affirming surgery, for whom additional considerations may apply; see advice on breastfeeding (also called chestfeeding) on the TransHub website. Information on promoting lactation in people who wish to breastfeed a child born by surrogacy, or who is adopted, is available from the Australian Breastfeeding Association.