The Syndrome of Insufficient Milk Supply and the Wisdom of Yoda by Lakeshore 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 "Criminal Minds" 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 breastfeeding.
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