Biologically when the placenta is delivered, it’s supposed to trigger hormones that stimulate milk production. Yet so many moms who want to breastfeed end up on formula within a week of birth because “their milk never came in”. While I don’t doubt that this can happen on occasion, why is it happening to so many people?
I have a theory myself but wondering if anyone knows more of the science behind why this is so common.
In: Biology
Excessive bleeding during birth can have some effect on milk production, as well as underlying medical factors, such as thyroid issues, diabetes, obesity, insufficiency glandular tissue, preeclampsia, to name a few. Then there are issues where the baby isn’t latching or transferring milk well so the body doesn’t get the signal to produce *enough* milk because more milk removal = more milk production.
I’m sure someone with more credibility will drop in to explain this better but, google tells me stress, other hormones, and health conditions can factor into this.
It’s always happened. That’s why you hear about wet nurses in ancient literature. They’d be hired to nurse babies if the mom couldn’t produce enough milk. I’ve never heard an explanation of why some women don’t make very much, but the amount of milk you produce has no relationship with the size of your breasts or whether you’ve had a baby before.
Breast feeding is also not as simple as people might think. The baby doesn’t always just latch on. A woman might need guidance on how to facilitate breastfeeding, such as how to position the baby, get the nipple in its mouth. etc. Then there are other problems like mastitis, or babies who have poor ability to suck because of developmental or neurological problems.
Medical conditions often impact how women are able to kick off that hormone production to lactate.
C-sections can delay milk production up to 10 days before it starts to work.
The process of lactation is triggered by a physical process as well. A baby needs to be able to efficiently nurse to trigger lactation and empty the breast. If at any point one of those things isn’t happening the production of milk slows. A baby with a tongue tie, for example, won’t be able to nurse as well as one who doesn’t.
Women with PCOS often have higher testosterone and often don’t release enough of the hormone to produce milk.
Stress can impact it.
There’s a lot of physiological processes that happen that mean lactation can fail. We also live in a faster paced world where women aren’t able to be home with a baby as long as we would ideally be (speaking mostly of the US).
My milk didn’t come in for a full week because I was in extreme pain after a c-section with no opiates after and being given the wrong type of painkiller (not Tylenol, which I requested instead of opiates, but an NSAID, which is NOT ok to give to someone with Gi disease and it destroyed my insides). After a week with no milk my baby was too sleepy and weak to do the work that BF demands. I was extremely determined and had intense assistance from La Leche League but in the end the only reason it worked was because I set a timer for every 2 hours for more than 3 hours around the clock, woke him up with a very cold washcloth and put him on the breast, pumped to keep production up, put milk on his mouth, into his mouth, did hours of skin to skin and sitting in a warm bath – many women just cannot deal with something like this, especially while in tremendous post-operative pain and without a supportive partner. I think if I hadn’t found out they were giving me an NSAID and stopped it so my pain stopped I might not have gotten any milk to come in at all.
Because I no longer have a colon or rectum I suffer from chronic dehydration pretty much all the time and BF exacerbated that immensely. I had to drink a quart of gatorade every day or I wouldn’t make enough milk.
Finally, a very, very large majority of women are not informed properly about how BF works and how to tell if baby is getting enough, which should ONLY be measured by the number of poopy and wet diapers and regular weight checks at the peds and not because baby is “squirming” or screaming constantly or “seems hungry.” Babies cry freaking CONSTANTLY and their GI systems are brand new, everything that goes into their stomach is upsetting especially depending on what the mother consumes. They also know when to stop as they are full when nursing and not with a bottle so it looks like baby “barely nurses” when on the breast but sucks down a whole bottle of formula so “must be starving” when it’s simply one is quicker, easier, and sweeter to get and the other is hard work so they know if they scream and hold out for it they’ll get the quicker/easier one. FED IS BEST there is nothing wrong with formula, but breastfeeding is very, very difficult for many women with various challenges like the ones I had.
I had 2 babies, both by c section. The first was a lazy sucker and couldn’t stimulate enough to get the milk production happening. She would take 1/2 hour just to get 50ml bottle into her. She is still a slow eater now at almost 20. The second was much better but what I think really helped was that I ended up back in hospital on a drip for an infection shortly after the birth. As I was getting really well hydrated at the hospital he got onto a 4 hour schedule. He was like clockwork. He sucked. I produced. It was a dream in comparison to his sister who I ended up getting so stressed about (which probably compounded the issue)
But yes, fed is best. Women should not be made to feel like a failure for not being able to breastfeed
Modern birthing practices, birth complications, postpartum interventions/separation of mother and baby, hormonal imbalances in the mother, lack of glandular tissue in the mother’s breast, tongue ties in infants, early supplementation when not medically indicated, lack of skilled support in hospitals. I think that’s most of the reasons.
The first thing a mother’s body produces is colostrum, but very little if it because the baby’s stomach is small. Actual breast milk takes longer to come in. This can be discouraging for anyone starting off with breastfeeding. Additionally, both mom and baby are figuring out how to breastfeed, so along with it taking longer for the milk supply to come in, both parties are figuring it out as they go. In the end, fed is best regardless of what that looks like. I found that triple feedings helped boost supply, but it’s still pretty exhausting.
Because many women are dehydrated and exhausted and bled an enormous amount and lack support after birth. Some almost die. And it happened all the time in ancient times too? That’s why there are wet nurses talked about so much in literature.
I wish I had all the answers (don’t all moms?), but I couldn’t produce enough to feed my babe. He was great right off the bat, he did everything right. But it was my body that said nah. I had internal bleeding after my c-section so I had transfusions, and on top of that, I have hypothyroidism. I fought long and hard to make myself make more breast milk for over two months, but literally nothing worked. I got so depressed and eventually gave up. Once I coped with that, I felt so much better – and finally untethered to a pump that disappointed me every time I was stuck to it.
Now I read comments and articles and I am so baffled – and disheartened- that no one ever told me that I had so many factors working against me. Everyone, lactation consultants included, just said “keep pumping, don’t stop, don’t give up.” I felt like a failure with it all. And now I’m mad for my past self and for so many others who go through the same thing.
Sometimes our bodies just simply can’t. And that’s ok. Thank goodness for formula and wet nurses. 🙌
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