With tears in my eyes, I reluctantly gave my son his first bottle of formula. I sat there asking myself why I was crying. It wasn't guilt. I knew I had nothing to feel guilty about. My child was losing weight and my doctor and my lactation consultant both said it was necessary to supplement. It wasn't what other people thought. I was never one to care about what others thought. It wasn't failure. I knew I had done everything right. I was breastfeeding every one to three hours and he was latched correctly. From everything I knew about breastfeeding from all that I read and words of encouragement from breastfeeding friends, my child should be gaining weight and certainly not losing it.
It finally hit me as he sucked down the last drop of formula, it was loss that I was feeling. Grief over the loss of our exclusive breastfeeding relationship. It was also anger, frustration, and disappointment. I was angry with my body. Why had it let me down? I had something called insufficient milk syndrome, something I had not read about in all my breastfeeding books. You see, I was one of the five percent.
Insufficient milk syndrome is kind of a catch-all word to cover people like me who, for one reason or another, do not produce enough breast milk to feed their babies. This is not written to be alarming or frightening to new breastfeeding mothers as this truly is a rare condition. Instead, this is written to share my personal struggles with breastfeeding and provide encouragement to mothers like me who find themselves in the approximate five percent of women who have problems with breastfeeding or milk supply issues.
Causes of Low Milk Supply
- hormonal conditions such as PCOS and untreated hypothyroidism
- breast hypoplasia or a history of breast reduction surgery
- cleft lip, cleft palate, or other issues that affect baby's ability to suck properly
- supplementing, nipple confusion, scheduled feedings, sore nipples, and other correctable breastfeeding problems
The majority of women with breastfeeding problems fall into the fourth cause listed for low milk supply. With the help of a lactation consultant, these can be worked through and corrected to allow for a successful breastfeeding relationship.
PCOS and Breastfeeding
PCOS, which stands for Polycystic Ovary Syndrome, is a condition that affects women's menstrual cycle, ovulation, hormones, and appearance. Studies have shown that women with PCOS are at greater risk for low milk supply. If you have been diagnosed with PCOS, you could experience problems breastfeeding. That being said, the majority of women with PCOS can breastfeed and even those who do experience difficulties can usually breastfeed with supplementing of infant formula.
Thyroid disorders can be treated with medication, thereby allowing for successful breastfeeding.
Breast Hypoplasia and Breastfeeding
Breast hypoplasia and breast reduction surgery can interfere with successful breastfeeding. It is often said that size doesn't matter. Many flat chested women have been told not to worry that size is not an issue. Be assured this is completely true! However, shape does matter. For me, breast hypoplasia was the cause of our breastfeeding problems. I always knew my breasts were small and oddly shaped, but I did not know the name for it, nor that it could cause problems with breastfeeding. Breast hypoplasia should only be diagnosed by a doctor, midwife, lactation consultant, or other qualified health professional. In breast hypoplasia, there is very little glandular tissue. Breasts are narrow and tubular shaped, set far apart, and one breast is often quite larger than the other. The good news is that, even with breast hypoplasia, more than a third of women can still breastfeed without any problems. Medications such as Reglan and herbal supplements including fenugreek have been used to help with these type of supply issues.
Cleft Lip and Breastfeeding
Cleft lips and a high palate or other anatomical issues with baby that interfere with proper latching can affect a women's milk supply. Cleft lip occurs when the area between the mouth and the nose does not close properly during fetal development, causing an opening in the upper lip. Likewise, a cleft palate is an opening in the palate between the mouth and the nose. Cleft lip may vary in appearance from a small notch to a complete opening into the nose.
Babies with cleft lip usually can breastfeed even before corrective surgery without too much difficulty. Babies with cleft palate may be unable to breastfeed. Consult a lactation consultant for proper techniques and positioning for breastfeeding a baby with cleft lip or palate.
Along with the conditions discussed above, there are some medical conditions such as galactosemia that breastfeeding is contraindicated for. Women who are HIV positive should not breastfeed.
It is important to reemphasize that it is very unusual to have a true milk supply problem. It is not uncommon for women to have a perceived supply problem when in actuality baby is gaining weight and receiving plenty of nourishment from mom. If you think you have a milk supply problem, you should consult with a lactation consultant before giving up on breastfeeding. Lactation consultants have extensive training and can help tremendously in solving breastfeeding difficulties. Even if supplementing is necessary, they can work with you on the best ways for breastfeeding to work for you.
Difficulty breastfeeding can take its toll on a new mother. Feelings of depression or guilt are difficult to cope with. Here are our best tips for coping with a milk supply problem.
- Surround yourself with supportive family and friends.
- Allow yourself time to grieve. It is okay to be upset, angry, and disappointed. Talking about these feelings may help you work through them.
- Use a supplementer, such as Medela's SNS (supplemental nursing system), if possible. If baby is able to breastfeed, it will help you to continue the closeness desired from breastfeeding.
- Cuddle with your baby. Probably the most therapeutic thing you can do is spend plenty of time cuddling with your baby. Nothing can help more to than seeing a bright smile, coo, or grin to reassure confidence and help mend the wounds of a milk supply problem.