Insufficient Milk

This is very close to home for me....as I was nearly down this track my self before I found the Sears web site and started feeding Ara on "Cue"
As Ara did not sleep through the night most people I talked to belive that I don't have enough milk...or it was not rich enough. I started to worry and think maybe I should give Ara formula as a top up (as suggested by my Plunket nurse). I had a bottle for Ara and would mix the stuff up but she wouldn't have a bar of it...good on her...it really smells.
My Mum also said that she didn't have enough milk...but she didn't read the Fussy Baby book...I'm a fussy baby...poor Mum.
Nana also said that she didn't have enough milk. I've not really talked to her about it as she's a bit upset...but at a guess Dad being born in '49 in the middle of the 4 hour routine and the stay in hospital for up to 3 weeks...well


This is an excerpt from Meredith Smalls book Our Babies Ourselves.

Insufficient Milk?

The syndrome is fascinating because it is a clear example of a disease being "invented," defined, and then perpetuated by culture at large. In only about 5 percent of the cases is there something making it physically impossible for a woman to breast-feed. Before bottle-feeding came into vogue, women rarely, if ever, reported a lack of milk. But when breast-feeding went out of fashion in the 1940s, this new syndrome appeared. The real cause of insufficient-milk syndrome appears to be a confluence of social changes hospitals took over the birth process and separated newborns from their mothers, doctors recommended interval feeding, and artificial formula presented a reasonable alternative. It is interesting to note that insufficient-milk syndrome appears only in Western industrial nations and has yet to be found in other cultures.
Why do so many women in affluent countries say they have no milk for their babies?

Breast-feeding is initiated by instinct, pushed by the biology of milk production, and reinforced by the actions of the baby. But there is also a psychosomatic element to breast-feeding. The let-down reflex, when milk flows from the ducts toward the nipple, is highly susceptible to anxiety and fear; and when no one is there to guide a new mother and she becomes anxious, this can set into motion a vicious cycle of failure. Beyond the problems with the letdown reflex, the physiology of breastfeeding can be interrupted by cultural style. When the baby is separated from the mother at birth, she misses the first and strongest impulse to suckle. When hospitals feed newborns with water or glucose from a bottle, they interrupt the initial bonding moments between infant and mother's breast. The scheduling of breast-feeding can also have a dramatic effect on milk production and on the feedback system between baby and breast. When women decide to feed on a schedule with long intervals of two or three hours in between, and then feed their babies in short bouts of under ten minutes, the lower fat composition of milk offered at each feed further complicates what should be a smooth process. The baby has been unfed for so long, has had a waiting period so much longer than its physiology was designed to handle, that it is extremely hungry and pulls hard on the nipple.

Many women experience nipple soreness, and believe that frequent nursing will exacerbate the problem. But the opposite is true-frequent nursing makes sure the baby is less ravenous and aggressive. Also, and probably more important in this situation, foremilk has come up behind the nipple at the end of the last feed long ago and has since lost most of its fat. Now, as the first fluid to come out, this particular long-awaited foremilk is extra-watery, low in fat, and therefore not very satisfying for a hungry baby. It then takes a while for the hind milk, still being manufactured and let down, to flow through the nipple and touch the infant's hunger button. And so feeding interval-that is, the style of nursing alters milk composition and can make the situation difficult for even the most well intentioned mothers. It is not that she doesn't have enough milk; it's that she simply waited too long and now the milk is of low quality and the baby knows it.

In other words, there really is no such thing as insufficient milk. Demographic studies that compare breast-feeding across cultures and within populations attest to this. Even nutritionally deprived women, unless they are nursing during a major famine, have plenty of milk, and the composition of their milk is the same as that of better-nourished women. Oddly enough, the greatest numbers of women who say they cannot produce enough milk are highly nourished, well-fed Western women.

I’ve also been looking at a few other places on the web of some other traps we fall in as Mothers.
Another mistake people make is that the baby nurses for a shorter length of time. They worry that the baby has de-latched because there is no more milk, but on the contrary, the breast makes milk “during” the feed so the breast is never truly empty. The baby in such a case has probably learned to nurse more efficiently and the mother is producing the milk far more readily to meet the demand and is having a good, fast letdown.

Getting worried the baby is hungry and offer a bottle after a feed. The baby gulps it down and assumption is the poor thing must have been starving. But the truth is that babies like to suck and a breastfed baby has not learnt that if he sucks at the bottle as if it were a breast, he's going to drown in the milk! But babies are opportunists - if there is an extra meal that is very easy to obtain, they'll find room in their stomach somehow. That doesn't mean they started out hungry however. Keep doing that and the baby will soon learn that it is easier to hold out for the bottle; he loses skill at breastfeeding (nipple confusion) and your supply will plummet due to the decreased demand. Many women wean in this situation, absolutely convinced that "my milk just dried up". Sadly, they are misinterpreting the baby's behaviour.

Using a breast pump leads to another misleading problem. The amount you pump has absolutely nothing to do with your milk supply as pumps are grossly inefficient at both getting milk out (estimates are that a good pumper can get about 20% at most) and stimulating supply. They don't stimulate the nipple in the correct way, and they don't provide the all important skin contact, baby smell (babies could well produce pheromones that we are not consciously aware of) etc. Pumping is a difficult skill for many, and a skill that some of us never really master, despite having no problems nursing. If your pumping yields are low, that is a “pumping” problem, not necessarily a nursing problem.


Must dash...Ara is snorring really loud
Ps...also see Linda F Palmer as well....she wrote Baby Matters