Insufficient Milk Syndrome: A Fallacy Becomes Reality
Posted: Breastfeeding » Problems » Milk Supply | February 1st, 2004
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By Dr. Linda Folden Palmer
One of the biggest fallacies surrounding breastfeeding is that it can provide insufficient milk. This fallacy was purposely created by formula manufacturers. The fact is, mother’s breasts are designed to produce as much milk as baby desires, whenever natural feeding is allowed. Careful studies demonstrate that most mothers who initially complain of insufficient milk are in fact producing adequate quantities, and their babies are growing normally.
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A survey of lactation literature seems to point to around 1.5 percent of all women around the world who physiologically cannot produce any, or sufficient milk. In the United States the percentage of mothers who desire to breastfeed but end up being unable to is closer to 15%. Interruptions of hormones during or after birth, interruption with bonding, lack of nursing in the first hour after birth, and stress during or after pregnancy are a few factors involved.
Besides these, many a faulty perception of insufficiency becomes a reality, however, with scheduled feedings and with formula supplementation, especially in the beginning. Regular, frequent stimulation of oxytocin and prolactin by the act of breastfeeding is required to keep milk levels flowing.
Supply and demand
When a baby cries with hunger but a schedule prevents feeding, mother’s body still responds to the cries with oxytocin release. But when the milk is not taken, prolactin is not produced; thus, there is no milk production when suckling does not occur. Just as a dog will stop responding to your call when no reward is given, hormone and milk production decrease when the body perceives that the need is less. Then when formula supplements are provided to an infant, the amount it takes from the breast is further reduced, again decreasing the amount the best believes it should produce.
If milk production is suspected to be inadequate, the last thing to do is to provide a supplement to baby. The first thing to do is to increase nursing time and frequency and make sure the mother is not dehydrated. The milk supply can be quickly renewed within a few days in this way if supplementation or infrequent feedings have caused decreased production.
Am I full yet?
In addition to self-serving marketing, poor medical advice and misinformed family advisors, another reason many mothers feel they have inadequate milk is that a few days after birth and then for several weeks more, there is a sensation of engorgement. This sensation is natural in the beginning and is probably designed to guide mother’s behavior to get breastfeeding established.
After a while, as the breasts “figure out” the milk levels required and hormone levels adjust, this engorged sensation lessens or disappears and breasts remain less full, producing most milk only on demand. As this breast filling reduces, some mothers wait for prolonged intervals to feed until they feel their breasts are engorged. Every time this happens, the breasts fill more and more slowly and produce milk with less fervor. Hence, a natural process turns into a true problem.
Trying to maintain an engorged sensation can also lead to mastitis, an inflammation of breast ducts due to pooling of bacteria or candida. At this point, certain ducts do not produce normally. Slower but not inadequate milk production is the result.
Priming the pump
The production of any notable quantity of milk does not occur for two to four days after birth. This too is by design. If formula supplements are given during the period when there should be frequent suckling and taking of colostrums, the stimulation of milk production will be inadequate. In fact, the likelihood of breastfeeding is dangerously impaired by early formula supplementation.
The first few days of colostrums provide a high degree of important immune protection during this most vulnerable period. At the same time, with minimal fluid intake and little to digest, the infant’s system rids itself of excess fluid and develops balanced kidney control, clears intestine-clogging meconium and ramps up for its first attempts at digestion, with the help of some initial growth-promoting factors received from the colostrums. At birth, the system is not instantly ready to begin full digestive and elimination duties but needs a few days of “priming.” This is well known for premature infants but not always remembered in term newborns.
Any time mother’s milk production has diminished or disappears, which occurs during restricted access to a preterm baby in intensive care (which should not occur), relactation can be induced with frequent pumping and suckling and sometimes with hormonal supplements. By this same means, adopted babies can be breastfed as well.
Excerpted from Baby Matters: What Your Doctor May Not Tell You About Caring for Your Baby by Dr. Linda Folden Palmer.
Dr. Linda Folden Palmer consults and lectures on natural infant health, optimal child nutrition and attachment parenting. After running a successful chiropractic practice focused on nutrition and women’s health for more than a decade, Linda’s life became transformed eight years ago by the birth of her son. Her research into his particular health challenges led her to write Baby Matters: What Your Doctor May Not Tell You About Caring for Your Baby. Extensively documented, this healthy parenting bookpresents the scientific evidence behind attachment parenting practices, supporting baby’s immune system, preventing colic and sparing drug usage. You can visit Linda’s web site at www.babyreference.com.
References
F.A. Oski, “Infant nutrition, physical growth, breastfeeding and general nutrition,” Curr Opin Pediatr 5, no. 3 (Jun 1993): 385-8.
H.C. Borresen, “[A questionable guideline on introduction of solid food to breast-fed infants,]” Tidsskr Nor Laegeforen (Norway) 114, no. 25 (Oct 30, 1994): 3087-9.
D.J. Chapman and R. Perez-Escamilla, “Identification of risk factors for delayed onset of lactation,” J Am Diet Assoc 99, no. 4 (Apr 1999): 450-4.
K Nemba, “Induced lactation: a study of 37 non-puerperal mothers,” J Trop Pedatr 40, no. 4 (Aug 1994): 240-2.
