Sometimes mothers doubt their capacity to produce and think their babies need more than they can provide. However, most moms CAN produce enough milk to satisfy their babies' needs.
Certain health conditions in the mother can cause her to have a low milk supply, but they're not common. Most cases of low milk supply are simply due to lack of stimulation. In other words, if the mother doesn't nurse her baby frequently and on-demand, her brain will slow down the production.
The fact that a baby doesn't fill up from his mother's breast can be due to many reasons. I strongly believe that finding the cause is crucial to get the right treatment. Babies are meant to nurse; that's their natural instinct. But when that's not possible, it's important to find out why that is happening.
In the following lines, I'd like to summarize the most common reasons that a baby can't get enough solely from his mother.
Causes related to the mother:
A healthy mother is always capable of producing enough milk to satisfy her baby's needs. However, some conditions can cause the mother to have a low milk supply:
Hormonal imbalances: Conditions like untreated thyroid disease, dysfunctions in the pituitary gland, diabetes or blood sugar imbalances, Polycystic Ovary Syndrome (PCOS) are some of the causes that may interact with the hormonal component of lactation, especially when they're untreated.
Breast surgery: This is a grey area because not all breast surgeries can reduce lactation capacity. Usually, the more invasive procedures where a lot of glandular tissue is removed or when there's nerve damage, are the most problematic. However, it's tough to predict how this can affect the milk supply. I have had mothers with breast reduction surgeries that can produce fair enough milk for their babies. We can't really know until we try.
In one opportunity, a pregnant mom with a breast reduction called me and said her doctor told her that she would have a 50% chance of having a full milk supply. I'd like to know from where this physician took that magic number.
Congenital malformations: Some women are born with breast anomalies affecting their glandular tissue. Conditions like hypoplasia (not enough mammary glandular tissue), symastia, hypermastia, or Poland Syndrome can affect their milk supply. On the other hand, it's important to highlight that, like in breast surgery cases, there's no way until now to predict HOW or to what extend that capacity will be affected.
In any prognosis case, the mother should be ready to do her best to develop a full production capacity.
Causes related to the baby:
On occasions, we might be facing conditions in the baby, causing an impediment to feed efficiently. They are related to either structural restrictions or neurological problems. Even with an accurate diagnosis, it's very hard to predict how that can affect their ability to nurse. However, they can put a red flag to take extra measures to help the baby to breastfeed.
Oral restrictions: Tongue, lip, or buccal ties are a very common cause of breastfeeding difficulties. Babies with cleft lip or palate can also face challenges to seal a latch. When a baby can't move his mouth's muscles to suckle on the breast, that may affect his capacity to remove the milk. The presence of a tie can manifest in different ways, including a chronic need for supplementation, even when the mother reaches an abundant milk production by pumping.
In this particular matter, the mother may believe that her supply is the problem when in reality, her milk supply dropped or never fully built because of the baby's oral restriction. Remember that breastfeeding is a work of two.
Body constraints: Babies breastfeed with their whole bodies. If a baby is not comfortable in certain position, he won’t be able to nurse efficiently. If he can’t move his head to one side because of a neck tension or torticollis, he’ll probably have difficulties latching on that side too. Some birth injuries can also affect. A baby in pain may be resistant to latch on in various positions, and eventually show signs of aversion to nurse if he’s continuously forced to the breast.
Congenital disease: A baby with a heart condition, digestive disease, or any other congenital problem might be affected with incapacity to nurse efficiently or to get too tired at the breast.
Prematurity: A premature baby might present dysfunctions in his suckling capacity that may require alternative supplementation sources. It's important to don't deny the mother to spend time skin to skin and allow the baby to nurse, even for short periods, as much as the baby's stability allows it.
Special needs baby: A baby with special needs can see many of his body functions compromised, including his capacity to breath-suck-swallow coordination. Usually, these babies benefit from their own mother's milk, but the mother will require professional assistance and lots of support to keep her milk supply and nurse.
As you can see, causes are multiple, and treatments widely vary. I hope these lines' central message is clear: We can't assume our baby can't breastfeed or mother can't provide. That is not the natural law, and luckily science offers us multiple options and professional therapies to overcome most challenges.
And, if, after all, the baby seems to keep needing supplementation, that doesn't mean the mother should stop breastfeeding. Every little drop counts and can bring exceptional benefits to the baby, even if he needs additional nutrition sources.