Asymmetric Milk Production: Is it a problem? What can I do?
This is a photo of one of my morning pumping sessions when my baby was about 11 weeks old. The bottle on the left shows the 4oz that was collected from the left breast, and the bottle on the right shows the less than 1oz that was collected from the right breast. As any pumping parent knows, this can be extremely anxiety-provoking!
The truth is, most lactating individuals will have a "good side" and a "bad side." Non-lactating individuals usually notice a slight discrepancy in breast size and nipple appearance on each side. Some asymmetry is simply due to normal variations in human anatomy. If a parent has had surgery or injury to one breast, that alteration in anatomy can also affect milk production on the affected side. However, there are also some behaviors that can affect the asymmetry. Many babies have a preferred side to nurse on, whether that is due to a birth injury, congenital torticollis, or just their personal comfort for some other reason. Many parents also have a preferred side to hold the baby on (keeping their dominant hand free for multi-tasking for example!). If the baby consistently nurses more frequently, longer, and/or more effectively on one side than another, that side will be stimulated to produce more milk. Breastfeeding is all about supply and demand. Demand more milk, and more supply will follow! Asymmetry can also follow an episode of a plugged duct or mastitis which can lead to a temporary decrease in milk supply on the affected side.
So is it a problem? And what can we do about it?
If your baby is absolutely refusing one side, suddenly develops a preference that was not there before, or you suddenly notice a drop in supply, it is a good idea to check in with your pediatrician and your doctor or lactation consultant for an exam to see if there is a problem that might be causing this. But if baby is feeding and growing well, there is no need to worry about this asymmetry. Baby will compensate for the different levels of supply by taking what they need from each breast. If you want to try to even things out, you have some options.
Start each feed on the side with lower supply
Feed twice as often on the smaller side if you only feed on one side per feeding
Pump on the smaller side only after a feeding or two
Add an extra pump session for only the smaller side
As you are trying to even things out, you must take care to avoid plugs in the larger side that can lead to mastitis. If it becomes full and uncomfortable, express some milk to comfort. After a few days to a week of doing these things, you will likely notice that your supply has started to even out on each side (although there is likely always going to be at least a slight difference between sides, it is impossible to get it exactly even!).
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