The Syndrome of Insufficient Milk Supply and the Wisdom of Yoda
Medical Breastfeeding Medicine Clinic
An approach to low
milk supply is here because I'm not
suggesting this is the only cause.
Intentional title. I think it's really called "perceived insufficient milk
supply" but I'm an allopathic doctor and as I understand that description, I
need a disease to talk about. I'm also a big geek, and as I understand that
definition, I should be able to quote Star Wars. Hands down, my favorite quote
is from Yoda in the "Empire Strikes Back" when Luke is training to be a Jedi, in
a swamp. Luke is having a hard time with this Jedi stuff. Yoda says ""Do,
or do not. There is no try." Hearing it quoted by Shemar Moore on
didn't hurt to impress it upon my memory.
I went on and on about possible physiologic explanations for low milk supply
here, so this isn't written about those mothers who
have explanations for low supply, or can't find an explanation for their low
supply. It is for those mothers that misperceive their actual supply. This
idea that mothers are supplementing and weaning because they feel as if they
have "no milk" or "I can't satisfy him" is as important as Star Wars. It's a
cultural phenomenon. It's everywhere. It's marketed, and grosses lots of money.
And the story is passed down from generation to generation. And if you have no
Yoda to inspire you, well, there may be a dark side. At about 3:00 am. When
you don't understand what the baby is doing. And you are starting to believe
all those subversive messages that are so pervasive.
According to Gatti (J Nurs Scholarsh. 2008;40(4):355-63.) about 35% of women
cite perceived insufficient milk supply as a reason for weaning. Other authors
go as high as 80%. The most common reason for the perception that a mother's
body can't make enough milk for her baby is lack of confidence and this idea
that she can't satisfy your baby. Crying is a big deal too. And moms always
seem to blame the crying on themselves first without looking for other reasons
the baby might cry. Like an older sibling who just knocked them over.
So what else may lead to the "dark side" thoughts. Well, lack of social support
for one. Interestingly, one study put the blame squarely on the mother-in-law's
disapproval. Perhaps it's marketing practices of infant formula companies. Ya,
I'm going to skip the "perhaps." Maybe it's hospital practices like separation
of the mother and infant, or poor, evidenceless- based practices. Or maybe
providers get in the way with my "3Bs" of bilirubin, birth weight and blood
sugar. Maybe it's under-education of what a normal newborn is supposed to do. Of
course, maybe "I don't have enough milk" is a socially acceptable way to stop
What it is, at its root, is lack of confidence, for whatever reason. That the
body that created the beautiful baby can't possibly satisfy him.
As wise as I believe Master Yoda is, I'm going to quote myself here: Why don't
we trust our bodies post-partum? I don't know. But I hear over and over that the
formula is because "I am just not satisfying him." Of course you are. Babies
don't need to "eat" all the time- they need to be with you all the time- that's
the ultimate satisfaction.
Jenny Thomas, MD, IBCLC, FABM, FAAP
More info on causes of low milk supply: http://www.drjen4kids.com/soap%20box/lowmilk.htm
More in on the normal newborn (quoted above): http://www.drjen4kids.com/soap%20box/normal_%20newborn.htm
The Three "Bs": http://www.drjen4kids.com/soap%20box/main.htm