Condition | Comments/explanation/examples | Management |
Maternal | ||
Breast surgery |
| Optimize breastfeeding technique and any other contributing factors, while monitoring infant's weight gain. Use pumping after feeds to increase milk supply. If infant's weight gain is inadequate, consider supplementation. |
Nipple conditions |
| Assess cause, and optimize nipple care and breastfeeding technique. Continue breastfeeding to stimulate milk production. Refer to UpToDate content on nipple pain during breastfeeding. |
Medications associated with decreased milk production* |
| Optimize breastfeeding technique; consider alternative medication if possible. Refer to UpToDate content on postpartum contraception and to the LactMed database*. |
Hormonal |
| Optimize breastfeeding technique while monitoring infant's weight gain closely. Assess for the cause, and treat if possible. The degree to which these factors affect milk production and ability to breastfeed varies with the cause and severity. |
Other |
| |
Infant |
| Optimize breastfeeding technique; refer to a lactation consultant or other expert in swallowing disorders. For ankyloglossia, consider frenulotomy. |
Mother and infant dyad |
| Room-sharing (including in the postpartum period). Optimize breastfeeding technique; refer to a lactation consultant if needed. |
PCOS: polycystic ovary syndrome.
* Refer to the LactMed database for information on specific medications. LactMed, produced by the National Library of Medicine, is a free, authoritative reference for lactation compatibility for prescription and over-the-counter drugs. It provides data on drug levels in human milk and infant serum, potential adverse effects on breastfeeding infants and lactation, and recommendations for alternative drugs.Do you want to add Medilib to your home screen?