How can I support a mother experiencing low milk supply while ensuring the infant's nutritional needs are met?

Support for a mother experiencing low milk supply should begin with a thorough breastfeeding assessment by a skilled practitioner. This includes asking about feeding concerns, frequency and duration of feeds, observing the baby's sucking and swallowing, checking the baby's contentment after feeds, monitoring weight gain and nappies, and examining the mother's breasts and nipples to identify any issues affecting milk transfer or supply ¹.

Interventions to support milk supply include:

• Adjusting positioning and attachment to improve effective milk transfer ¹.
• Encouraging frequent, responsive breastfeeding to stimulate supply, as milk production is supply-and-demand based ¹.
• Supporting expressing breast milk by hand or pump to increase milk availability and maintain supply ¹.
• Referring to additional support such as lactation consultants or peer support groups for tailored advice and encouragement ¹.li>

If supplementation is necessary to meet the infant's nutritional needs, it should be done carefully:

• Discuss the use of first infant formula as the only formula needed in the first year unless specific medical needs exist ¹.
• Provide information and face-to-face support on safe formula preparation, responsive bottle feeding, pacing feeds, and recognising feeding cues to avoid overfeeding ¹.
• Support the mother to maintain breastfeeding while supplementing, explaining possible effects on milk supply and strategies to sustain it ¹.

Throughout, provide respectful, individualised care that acknowledges the mother's preferences, cultural context, and emotional wellbeing, offering reassurance and continuity of support until breastfeeding is established or alternative feeding is safely in place ¹.