Breastfeeding Myth – Many women can’t produce enough milk for their baby.

While it is known scientifically that most women can produce enough milk for their baby/babies (about 98%), many mothers in our culture feel it is a struggle to produce enough milk. Most women who believe they don’t have enough milk are reassured by talking to a volunteer breastfeeding counsellor or peer supporter. Often behaviour that leaves a mum feeling she does not have enough milk is very normal behaviour. Baby wanting to feed very often in the early weeks is normal. While some babies are happy to eat and sleep many others need to feed very often and be held in between feeds before they will fall asleep and be content to be put down.

However there are some women who are at risk of poor milk supply. These include:

Mothers with wrong or poor information about breastfeeding
Mothers of premature babies
Stressed mothers
Women who needed help getting pregnant (what made it difficult to get pregnant may interfere with their ability to make milk)
Mothers of a sick baby (baby struggles to remove milk from the breast)
Women who did not notice changes in their breasts during pregnancy
Very young mothers

Even many of the above mothers do go on to feed their baby exclusively.

Key things to keep in mind about the production of breastmilk are as follows:
*The more milk that is removed from the breast, the more there will be.
*The emptier the breast, the faster it will produce milk.
*The fuller breast will slow milk production until milk is again removed from the breast.
*Baby’s wants are baby’s needs.

One problem many women have is not understanding how long a baby can take to feed. A baby needs to double his/her birth weight between 4 and 6 months. If you had to double your weight how would you eat? Very often and through the night I suspect. Sometimes a feed is a snack, baby just wants one side. Other times baby wants 2 courses i.e. both breasts. Other times baby may want a multi course meal e.g. Feed both breasts for about half an hour (say starter and main course), have a snooze for 20 minutes, want pudding now that the first two courses have settled and left a bit of space. Feed for 10 minutes. Snooze for 30 minutes, fancies another portion of pudding, so feeds for 20 minutes on one breast and falls asleep for 2 hours (at last). Mum breathes a sigh of relief and lies down for a rest herself.

Women are often concerned because their breasts feel ‘empty’ i.e. their breasts feel much lighter after baby has fed and so there couldn’t possibly be any milk left if baby still wants to feed. Be reassured that each time baby feeds there will be milk available as most milk is being made during a feed. If baby is fussing on an ‘empty’ or light breast it may be because the flow is slower than baby would like. Don’t be afraid to swap sides at this point as the other ‘empty’ breast will have been making milk very fast and there will be some milk available at a faster flow.

It is no wonder women often don’t feel they have enough milk for their babies when our society has a distorted image of what babies really need i.e the perfect baby that feeds and sleeps in a pram for several hours. Most babies as I said earlier are not like this. Babies need held lots awake or asleep and most need fed often.
Women don’t need condemned for not breastfeeding, they do need a supportive environment in which to breastfeed and our society has a huge responsibility to provide this. After all ‘not breastfeeding’ costs everybody, breastfeeding being the basis of cost effective health care. As Dr James Akre says women don’t breastfeed, society does.

We need to stop blaming women for not having enough milk and become a society supportive of breastfeeding. How can we do that?
Be realistic about what new mums really need in terms of help and support. New mothers need help with the house especially food. They need to be allowed to rest in the weeks after birth and not expected to go shopping with their mother-in-law without the baby!!!
Instead of suggesting a bottle of breastmilk substitute, family members could bring round food instead – if this happened breastfeeding rates would no doubt soar.
Instead of suggesting a bottle of breastmilk substitute to improve weight gain (where weight gain is slow as opposed to what is called “failure to thrive”) health professionals could read about breastfeeding in a good breastfeeding book and advise accordingly, which again would produce improvement in breastfeeding rates.
Hospital practices could be improved eg encourage much more skin to skin.
Sleeping with your baby could be condemned less and safe practice could be encouraged. Skin to skin contact improves milk supply as does sleeping with your baby. Skin to skin contact can be done anytime mum and baby enjoy it.

So what can you do to help the women around you? Learn as much as you can about breastfeeding appropriate to your area of responsibility. The new edition of La Leche League’s ‘Womanly Art of Breastfeeding’ is a good place to start.
Read the ‘Politics of Breastfeeding’ by Gabrielle Palmer.
Join at least one of the breastfeeding support organisations.
Smile at a women with a baby, you don’t know what kind of a day she is having.
Don’t blame breastfeeding for all a mother’s woes – stopping breastfeeding swaps one set of problems for another often worse set of problems. Mothering is hard work so no wonder breastfeeding mums are tired.

If you are concerned about your baby’s weight gain or behaviour please do read http://www.llli.org/FAQ/enough.html, phone one of the volunteer help lines or contact your local peer supporters.

Sarah McCann.
Sarah is the only lactation consultant in private practice in Northern Ireland. She has also been volunteering with La Leche League for the last 15 years.