Got Milk?

At his one week appointment, my newborn son, Liam, was not back to his birth weight.By day 12, he had lost over 20% of his birth weight. I was completely baffled by his lack of weight gain because my son was nursing around the clock. My pediatrician was worried and told me that we had to start supplementing with formula. If we didn’t supplement, we were risking Liam being hospitalized and diagnosed as “failure to thrive”, a term, which according to Johns Hopkins Children’s Center, is used when a child’s rate of weight gain is significantly low.

After discovering Liam’s weight loss, I immediately met with a lactation consultant. She measured how much milk he was getting by weighing Liam before and after a feeding, and we discovered that I was barely producing milk. As a new mother, I was devastated to learn that my son was essentially going hungry.

Prior to giving birth, I assumed that breastfeeding would come naturally and easily. The American Academy of Pediatrics recommends that babies are exclusively breastfed for the first six months and then continue to be breastfeed through their first year. According to the Centers for Disease Control and Prevention, American women are hearing the advice and 77% of babies in the United States are breastfed at birth. Of those, only 47% are still being breastfed at six months.  

However, I was in for an unexpected challenge.

According to womenshealth.gov, breastfeeding has multiple benefits for both mothers and babies. Breast milk is easy for babies to digest, and the antibodies in breast milk have been found to protect against various diseases including asthma, respiratory infections, gastrointestinal diseases, and type 2 diabetes. WebMD states that breastfeeding may also reduce the risk of Sudden Infant Death Syndrome (SIDS) by 60%. Breastfeeding has health benefits for mothers as well. It’s been linked to a lower risk of type 2 diabetes, breast cancer, ovarian cancer, and postpartum depression.

Lowmilksupply.org is a resource developed by two lactation consultants, Diana West and Lisa Marasco, specifically for nursing mothers who are struggling with milk production.  According to lowmilksupply.org, production of breast milk is based on supply and demand. If milk is being emptied from the breast, then more milk will be made. The emptier the breast, the more milk produced. 

This is where it gets tricky. According to the Mayo Clinic, formula feedings should be avoided or limited, because they will decrease a baby's demand for breast milk, which then lowers the milk supply. Thus, a mother who is told to supplement with formula is, essentially, working against herself.

"For most women who have low milk production, it is a secondary condition,” says Alyssa Schnell, a certified lactation consultant at Sweet Pea Breastfeeding Support in St. Louis. “What I mean by that is that milk production is driven by frequent and effective breast stimulation and milk removal. So, if a baby isn’t nursing frequently enough or effectively enough to drain the breasts, then that signals the brain to make less milk. So, in most cases, the primary issue is a mother who isn’t nursing frequently enough or a baby who isn’t nursing well enough."             

However, Schnell also says that there are some mothers who have primary low milk production caused by medical conditions. These include limited breast tissue, previous breast surgery or injury, thyroid problems and hormonal imbalances. According to WebMD, true milk insufficiency is rare and most women should be able to produce enough milk.

In my case, my doctor could not determine any medical reasons for the low supply. To help increase my milk production and to counteract the effects of supplementing with formula, I was put on a regimen that involved using an electric breast pump several times a day, in addition to regular feedings. The pump was an attempt to stimulate more production by emptying the breast more frequently.

At one point, I was pumping 12 times a day, yet I could not get my supply to increase.  I met with three different lactation consultants and did everything they suggested. I took the herb fenugreek, which the lactation consultant suggested I take. According to the National Center for Complementary and Alternative Medicine, fenugreek is not proven to help with lactation. I also took a prescription medication called Reglan, which is sometimes used to help increase the volume of breast milk produced by increasing the secretion of prolactin, the hormone that stimulates milk production. 

         In the end, nothing worked, and I struggled with a low supply until I weaned my son at six months. Although I breastfed, I had to supplement with a bottle of formula at each feeding.  I reassured myself that a little breast milk was better than none, but I was continually frustrated and felt like a failure. As for my son, after I began to supplement, he gained weight, and today, he is a healthy and strong one year old. Michelle Whitacre

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