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why are there so many mothers who dont make enough milk- tf opinions

post #1 of 55
Thread Starter 
as i delve further into a tf lifestyle and way of eating i am struck by how many stories i hear of mothers not being able to make enough milk for their babies and needing to supplement or wean before one year. i just read sally fallon's account of her own breastfeeding struggles and am wondering what you wise tf mamas think is going on with this problem.

i used to assume that when women said they werent making enough milk and had to quit breastfeeding that they really were simply uninformed and suspicious of breastfeeding and just didnt really want to breastfeed, or felt embarrassed to breastfeed so they used the "not enough milk" excuse to quit, because who is going to judge a mama trying to save her baby from starving, right? but after reading sally's testimony and other moms blogs about not making enough milk it seems like they genuinly believe they HAD to start formula (often homemade).

anecdotally, i ran into a woman recently who had a 4 month old babe and asked me if i am breastfeeding, which i am, she then told me that her baby had been super fussy and she had started giving formula and the fussiness disapeared and now she only nurses once a day.

how are people determining that they dont make enough milk? rae they weighing baby after feeds and finding that baby isnt getting much? are they pumping and measuring? or is baby simply "fussy" and they assume baby isnt getting enough milk and thus begins the cycle of supplementing and the start of weaning?

according to sally fallon she says women can make enough milk if they have the right diet but she also says that in other animal species some individuals just dont produce much milk and their offspring must be "bottle fed or die".here is a link to that quote from ms. fallon
http://www.westonaprice.org/children/saga.html

what do you all think? is it cultural- ie. our culture doesnt truly support breastfeeding and it undermines our success at it by advertizing formula ect? or is it truly a physical problem of women having such poor diets that they cant produce enough milk? or is simply luck of the draw- that some women arent good milk makers despite a good diet?
post #2 of 55
Quote:
Originally Posted by arismama! View Post
what do you all think? is it cultural- ie. our culture doesnt truly support breastfeeding and it undermines our success at it by advertizing formula ect? or is it truly a physical problem of women having such poor diets that they cant produce enough milk? or is simply luck of the draw- that some women arent good milk makers despite a good diet?
I think it is a mix. I've met women who claim they couldn't nurse, but when they tell you their story you see elements where they were undermining themselves and causing their own low milk supply. Then you meet women who have obvious hormonal imbalances that either produce too much or not enough. Then you have non-hormonal physical issues, which isn't as common. It seems the cultural and hormonal is on the rise, but the hormonal issues are rising much faster. Overall, I think it's a big, waving red flag from the endocrine disruptors in our food supply and environment.

Making it a cultural norm would minimize the women who can't make enough for cultural reasons, but it's not going to solve the hormone problems.
post #3 of 55
Yes, to what the pp said. Its a mix.
I have 2 friends who really really really want to breastfeed, neither of them can do it fully. Both of them have used the SNS or Lact-aid with donated milk or formula. They keep "breastfeeding" though.
Both of them, end up being able to satisfy their child by age of 6 mos and older because then there are also solids in the game and then the need for breastmilk becomes lower.

On the other hand I know lots and lots of women who have simply not had the right information or support to continue. Some just don't want to.

In the animal world it happens as well that some individuals do not produce milk, but this is rare - asked my BIL who is a biologist. The rate in the animal world is very different from that in the human world.
With that in mind I do think it is a big mix, cultural, nutrition and hormonal which is then linked to nutrition.
post #4 of 55
Personally, I think its mostly misiniformation and an unsupportive environment. Second to that, IMO is bad diets/hormonal imbalances which in this day and age are essentially the same thing. People are getting So many hormones from the food they eat due to GMO crops, GMO milk/dairy, etc that even if they think they're eating 'healthy' they're really not. And its not their fault. Its just very, very hard to find food thats not GMO and/or full of artificial flavors, colors, hormones, etc.
post #5 of 55
I think it's a combination of factors.

There ARE some physical problems that prevent women from producing enough milk, and that keep some women from producing any milk. In "the old days", a few things could happen: the baby would die, the baby would be nursed by another mother (or mothers) in the community, the baby would grow VERY slowly and be sickly (and probably die of disease due partly to malnutrition) or they'd start solids very young to supplement the breastmilk. Wet nursing/cross nursing was probably the most common solution.

In "the old days", women didn't have cosmetic breast surgury, nor did they have surgical treatments for breast cancer. Either they didn't get cancer as much, it was treated non-surgically, or the women didn't survive to reproduce.

Modern obstetrical practices can mess up breastfeeding. Not getting the baby to the breast right after birth, and restricting breast access in the first week can interfere with the development of the milk supply. Excessive blood loss, retained placental fragments (commonly caused by impatient birth attendents), and some drugs used during and after birth may interfere with breastfeeding as well. Some women are VERY sensitive to that first week or two- if the supply isn't properly established right at the beginning, some women are unable to build up a full supply after that. Others are less sensitive, and can fully BF in spite of these kinds of difficulties in the beginning.

Then there's poor breastfeeding management. Besides the stuff about the first few weeks mentioned above, some women are encouraged to space out feedings, get the baby to "sleep through the night", use pacifiers, etc. If a woman is unwilling to NIP, that generally leads to less frequent feedings.

Then there are physicians who don't support breastfeeding. Many of them get women worried about milk supply when the baby is doing just fine, and that can begin the supplement-reduced supply cascade. Few pediatricians will offer breastfeeding assistance, or a referral to a lactation specialist, rather than suggesting formula. There's also the fact that pediatricians are even LOOKING at baby's growth/milk supply issues. Without this oversight, many babies might continue to grow and do OK on breastmilk alone, even if they'd do better with some supplementation.

Not all babies who "seemed to be much less fussy" after drinking a bottle of formula truly needed to be supplemented. Maybe the baby was less fussy because he or she was worn out from trying to digest the heavy formula. Maybe it was day 2 of a growth spurt, and the milk supply was ALMOST catching up, and in another day the problem would have resolved on its own. Or maybe supplementation was truly needed in that situation- possibly because of obstetrical practices that interfered with the development of her milk supply initially. Or maybe she was one of those women who would have needed a friend or relative to nurse her baby once or twice a day back in "the old days."

It's likely that maternal nutrition plays a role in milk supply as well. I'm guessing that, if this is the case, we're talking about the mom's nutrition going back years and years, probably back to her own childhood. Poor nutrition might have prevented her milk glands from developing properly. Or maybe it only goes back a year or two, and if she had a good supply of nutrient stores, she'd be able to make richer/more plentiful milk. And obviously, good nutrition while lactating means a healthier mom (who's not feeling so drained or overwhelmed) and possibly more nutritious milk, although women can still produce plenty of milk in sub-optimal conditions. I suspect this varies greatly between individuals: some women are able to produce plenty of good milk no matter what, while other women are much more sensitive to the effects of maternal diet on milk production.
post #6 of 55
Another vote for mostly misinformation. In no particular order:

babies need to nurse often- usually more often than our culture teaches us
babies need to nurse more at night- also not popular in our culture
pacifiers interfere with milk production
artificial nipples interfere with the breastfeeding relationship
being separated and pumping is bad for supply and the nursing relationship (Disclaimer- I realize this is largely unavoidable, but we're discussing what's happening to milk supply- this is a factor)
pumping is not the same as nursing (see above)
spoonfeeding lots of solids messes with supply
other sucking can interfere with supply (sippy cups, bottles, etc)
juices and other milks can interfere

There are VERY few women I've heard of who avoided all of the above and had supply problems. VERY few. Do they exist? Yes. But historically wet nurses- aunts, cousins, etc- would have been available in those rare cases.

-Angela
post #7 of 55
I think the numbers of women who have an actual inability to produce enough milk are teeny tiny. I've always heard the "I don't make enough milk" saying as "My doctor scared the carp out of me by claiming my kid is FTT" or "I don't know a thing about babies and their growth patterns so I thought my kid wasn't getting any milk" or "My baby seemed skinnier/longer than FF babies so he must be starving to death" or "My baby wants to BF every 2hrs and I don't want to do anything near AP, so he is obviously not getting enough"

etc etc

I suppose for those very few women who are actually experiencing a problem, hormones in our food and junk food aren't really helping. But I doubt that it would alleviate much of this "starving BF kid syndrome"
post #8 of 55
I think it's almost entirely lack of support, lack of information and lack of drive. The quality and quantity of a mother's diet doesn't dramatically effect her ability to produce milk. Studies in developing nations have found that mothers, even when faced with conditions of famine, can produce adequate amounts of quality milk.

Sally Fallon is one of the most uninformed breastfeeding resources out there. Her consistent misinformation regarding breastfeeding is the only reason I have not yet joined WAPF.

Now, don't get me wrong, I strongly feel that pregnant and nursing mothers should eat natural, whole foods in abundance, but blaming breastfeeding failure rates on poor nutrition is casting blame in the wrong direction.
post #9 of 55
Honestly, I think it is related to the fact that the breasts supply whatever is demanded. If a woman keeps telling herself, or being told, that she doesn't have enough milk, she'll stop suckling the baby as much. If, on the other hand, she has a support system of people who will say, as my wise sister did to me, just let the baby nurse as often as he wants to...well, then the supply will tend to meet the demand. The breasts will increase their output in direct relation to how much they are used, whether from pumping or nursing. Most of the mothers I've met with the problem were too quick to say, oh, I just didn't have enough milk, when in fact, they didn't really take the time to try to increase the supply by increasing the demand. It is simple, but not easy, and in our overly-hurried world, slowing down to relax and enjoy nursing in which no actual milk is being-- at that moment--produced, seems to some people unfruitful and a waste of time. But that is precisely what is necessary for the body to increase the milk supply. And of course, I recognize there are very real exceptions, but most of the women I have met that struggled with this, I believe, didn't take the time it requires, but gave up too quickly. Most, I repeat, not all.
post #10 of 55
Does anyone think it could be stress related? I am super sensitive to stress. I stop ovulating the second I feel stressed. (even a minor argument or a late fee on a bill or something)

In this case, with these lactating moms- stressors: a new baby, a bad diet, unsupportive fast-paced society, financial issues, faced with going back to work shortly, short or non-existent baby-mooning period which was so common for our ancestors, all of these are such common stressors for moms now days, and we probably all handle this stuff differently. I bet lots of moms are so stressed out their bodies react accordingly. What do you all think about this idea?
post #11 of 55
That's a good point too DesertMommy. And "feeling stressed" has as much to do with external stressors as it does with our reactions to it. Poor nutrition (especially lack of B vitamins) can make stressful situations feel more intense, and exaggerate physical responses to stress.

Remember that most traditional societies combined emotional support with nutrition, and just called it "nurturing." Every culture had special foods (such as liver) that were considered especially appropriate for expecting and new parents.
post #12 of 55
Thread Starter 
Quote:
Originally Posted by snowbunny View Post
I think it's almost entirely lack of support, lack of information and lack of drive. The quality and quantity of a mother's diet doesn't dramatically effect her ability to produce milk. Studies in developing nations have found that mothers, even when faced with conditions of famine, can produce adequate amounts of quality milk.

Sally Fallon is one of the most uninformed breastfeeding resources out there. Her consistent misinformation regarding breastfeeding is the only reason I have not yet joined WAPF.

Now, don't get me wrong, I strongly feel that pregnant and nursing mothers should eat natural, whole foods in abundance, but blaming breastfeeding failure rates on poor nutrition is casting blame in the wrong direction.

yes, i too have read that even mothers who are literally in starvation can provide enough milk to sustain life in their infants. thats why fundamentally i find it hard to believe that many moms really cannot physically make enough milk
post #13 of 55
Interesting thread. I don't know of anyone who is into traditional foods other than myself and I still breastfeed my 16mo DD. At my school I was listening to other gals talk about how they 'just couldn't nurse them' in reference to their children. There are a couple of moms there who nursed until their children were 9-10 months and considered that extended breastfeeding because it was past 6 months. I think it has to do with the cultural image that only poor people nurse because they can't afford formula or something like that. I also think it has to do with advertising, at the hospital I went to they had a strict no forumula adds policy but the other two hospitals in town have tons of sponsorships from formula companies. Out the door of the hospital new moms get free diaper bags, bottles and formula. I don't know any moms from those two hospitals who've nursed beyond the first month. The two moms at my school who nursed their kids past six months both birthed at the hospital i went to.
post #14 of 55
I agree with much of what's been said already, but I think there's another factor, too, which Ruthla alluded to but that I feel compelled to expand upon because it was kind of ME three years ago.

I go back and forth on what would have happened had a hospital not been available for me, but I am pretty sure that I would have died in childbirth. Obviously, I didn't, but I did hemmorhage pretty badly and lost a couple of litres of blood. Afterwards, although DD nursed pretty well from the start and I was all about boobies all the time (I remember nursing her for about 5 hours straight when she was a week or so old) my milk never "came in". I nursed her literally EVERY opportunity I got. If she was awake, she was on the boob. And she was obviously, painfully, not gaining. My midwives - who were VERY reluctant to advise supplementing - stepped in at about day 15 and recommended that I do so.

I'm pretty sure this was related to shock, blood loss, stress, and anemia - all of which are not uncommon during birth nowadays, but pre-industrially, births like mine were pretty much a death sentence. That having been said, preindustrially people did not wait until their mid-thirties to have babies, and I have no doubt the outcome would have been different had I had my daughter 10 years earlier.

Anyway, I went on domperidone, nursed and pumped as much as I could, and after a couple of months my supply WAS sufficient for EBF. I can, however, completely understand why women who don't have the motivation or support that I had would give up. Supplementing AND nursing? Pretty much hell. It's the worst of both worlds - all the PITA of bottles, plus all the stuck-on-the-couch-OMG-I-have-to-pee of nursing a newborn. Plus stress!

Frankly, I don't think nutrition has much to do with it. I was raised on wild game and organic vegetables, my parents never bought into the low-fat thing and I ate well during my pregnancy. I think possibly endocrine disruptors could be a cause - although I don't think so in my case, and stress, and post-partum anemia and trauma and lack of information and lack of cultural support or context and just plain not nursing ENOUGH - but it seems to me that the only thing necessary nutrition-wise for adequate breastmilk is adequate calories for mom. Far too many really poor, really malnourished people survived the Industrial revolution for good nutrition to really have that much impact.
post #15 of 55
i agree w/ much of what's been said.
lack of support and knowledge in the hospital and post partum community (or lack thereof) is a big one. stress is definitely a factor at times. and personally of the women i know who have had this problem, the majority are vegetarians or close to it. i'm not saying this amounts to a scientific study-- there are obviously many other factors as discussed previously-- but in my own opinion i do not think it's a coincidence, either. from a standpoint of studying chinese medicine it makes sense to me. i also could see other maternal health history as being relevant. interesting question.
post #16 of 55
Quote:
Originally Posted by DesertMommy View Post
Does anyone think it could be stress related? I am super sensitive to stress. I stop ovulating the second I feel stressed. (even a minor argument or a late fee on a bill or something)

In this case, with these lactating moms- stressors: a new baby, a bad diet, unsupportive fast-paced society, financial issues, faced with going back to work shortly, short or non-existent baby-mooning period which was so common for our ancestors, all of these are such common stressors for moms now days, and we probably all handle this stuff differently. I bet lots of moms are so stressed out their bodies react accordingly. What do you all think about this idea?
Not in my case, at least. My adrenals bottomed out after Ds was born in spring of '06 from severe emotional stress, yet I still produced such an oversupply of milk complete with painful letdown. Almost 3 years later & I'm still in zone 7 (almost no cortisol) & am still producing a lot of milk & still experiencing let down (tho not painful - probably from going GF...)
post #17 of 55
I've really wondered about this, and it haunts the back of my mind when I think about another pregnancy...

I grew up hearing my mother talk about how wonderful it was to breastfeed and how she had such an abundant supply that she sold her extra milk to the hospital. I never once doubted my ability to make enough milk. I nursed my firstborn for over 3 years, always having enough milk (although knowing what I know now, my milk didn't seem very nourishing, as dd was always very very very skinny.) I had a pretty crappy diet, but didn't yet know better. Oh, and my daughter's birth was about as bad a hospital birth as you can imagine, and I didn't even get to hold her for 12 hours.

When my living son was born, there were once again complications. He got stuck, I hemorrhaged, we were separated a lot. I didn't know when they would "let" me nurse him, so I used the hospital pump, to make sure my boobs knew they needed to get to work. Right after that they let me nurse him, and I had nothing to give... he was HUNGRY, and somehow that moment set up our entire nursing relationship. I never had enough for him. How did I know? It was just obvious. He always wanted to nurse more. I knew how to breastfeed... I was confident that I could and that I would make enough... I knew to never restrict amounts or times or anything. He was on my boob as much as he wanted. I got him chiropractic treatment immediately, to help with his rough birth... so that wasn't a cause. But my boobs were always drained to the last drop. And he always wanted more. He took to food with gusto, but still wanted a LOT of boob. The older he got, the more food he ate, never let my boobs catch up. I started taking domperidone when he was almost TWO YEARS OLD because I still couldn't make enough milk for him, he was nowhere near ready to give up nursing, and I was exhausted... spending hours on the couch, nursing him. By that time my diet was significantly better (although I didn't know about my gluten-intolerance, so who knows how much I was digesting.)

I remember reading somewhere in the WAPF stuff that the breastmilk becomes less rich with each subsequent pregnancy. If that is true, it scares me. I want to believe that I can make enough milk for another baby, but... my confidence has been utterly shaken. I have addressed (by myself, no professional help) adrenal fatigue, my food allergies, and I think I'm made huge strides toward healing my leaky gut. So maybe I've got a whole new situation now. I sure hope so.

I personally feel like if even *I* could have a hard time making enough milk, anyone could. I think a lot of mamas really do struggle with low supply.
post #18 of 55
Quote:
Originally Posted by Junegoddess View Post
I remember reading somewhere in the WAPF stuff that the breastmilk becomes less rich with each subsequent pregnancy. If that is true, it scares me. I want to believe that I can make enough milk for another baby, but... my confidence has been utterly shaken.
I wouldn't be relying on WAPF for breastfeeding info.

It's possible that breastmilk does become less rich, although I think the difference if you space children appropriately (3-5 saves lives!) is minimal. My wonderful IBCLC-certified doctor told me that mothers almost always make more milk with subsequent children, so even if it IS less rich, there'll be more of it.

I would suspect you had a similar problem to me with the hemorrhaging. Before medical interventions, that was the #1 cause of death in childbirth - I don't think our bodies are adapted to recover from that easily.
post #19 of 55
Excessive blood loss/hemorraging is one cause of low milk supply - when the mom's body is focused on recovery from something that traumatic her body prioritizes what it can do - and the first priority is the mom's own body healing and everything else (even milk production) comes second to that (for good reason biologically!). Moms with low supply due to traumatic birth are a reality and shouldn't be dismissed as 'didn't have the right information' or 'didn't try hard enough.'

Another potential cause of low supply is women who conceived via ART - there are often underlying hormonal issues and even after getting pregnant and giving birth, a higher incidence of low supply.

Other physiological causes include hypoplastic breasts (i think that's the right term - the breast tissue doesn't develop properly, the breasts look tubular/torpedo-like instead of rounded, breasts don't grow much if at all during pregnancy, milk doesn't come in much. I have known moms with this condition who were able to nurse but it was typically only with supplementing, incredible dedication, and often with subsequent pregnancies b/c of how milk supply tends to increase with each baby).

PCOS is another condition that can have a negative impact on milk supply (again, due to the hormonal issues).
post #20 of 55
Quote:
Originally Posted by Junegoddess View Post
I remember reading somewhere in the WAPF stuff that the breastmilk becomes less rich with each subsequent pregnancy. If that is true, it scares me. I want to believe that I can make enough milk for another baby, but... my confidence has been utterly shaken. I have addressed (by myself, no professional help) adrenal fatigue, my food allergies, and I think I'm made huge strides toward healing my leaky gut. So maybe I've got a whole new situation now. I sure hope so.
I have found that my milk supply has gone up with every child, so this is not necessarily so. I have had a lowish supply with my 1st, then enough for my 2nd, with the 3rd a slight oversupply and with the 4th definitely oversupply. I have seen this pattern in many many mothers.
One thing that is very important is that the mother uses an abundant amount of fats and nutrient dense foods. Mothers who are on the malnutrition diet can have problems.
HTH
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