Updated: Feb 25, 2021
It is a common concern amoung new parents who plan on breastfeeding their baby. "Will I have enough milk?" "My grandmother said she couldn't feed my mother." "My friend had to supplement her baby." The list of anecdotal accounts of supply issues goes on. While these cases were absolutely true, here's why chances are, if you have a healthy pregnancy, your baby and your body know what to do to make enough milk.
Let me begin with the abbreviated history of breastfeeding for white people. I say white people because breastfeeding and mothering struggles for black women is an entirely separate political and humanitarian outrage that I encourage you to dig into.
In the 18th century, England, Dr. William Cadogan observed that infants were frequently dying. He noted that working, ordinary countrywomen exclusively breastfed their babies, while the rich fed their babies concoctions of wines, breads, cows milk, water etc before they were even put to the breast. Also, because the rich used wet nurses (slaves), there was a delay in getting breast milk into the baby. Due to societal, familial and religious traditions, many women in these rich households were not allowed to breastfeed.
Cadogan then began recommending to all mothers that they schedule their feedings - 5 times per day - and condemned sleeping with baby (later "experts" began suggesting limiting time at the breast). Little did he know that this affects the production of milk supply in the breast; supply and demand, as we say. Some baby's can stimulate enough milk with only 5 feeds a day, most could not and therefore "not enough milk" became an issue.
In swoops the commercial products of artificial milk, "saving" babies lives and making billions of dollars. I put that in brackets because, while the rich were benefiting from artificial milk, Nestle was using immoral marketing and false scientific claims to sell to third world countries where there was no safe water to use for powdered milk and many, many babies perished where exclusive breastfeeding would have prevented this. While there are absolutely times when a baby is not and can not receive enough breast milk and needs artificial milk, it is not usually as necessary as we have been led to believe.
By the end of the second world war, artificial feeding was becoming the norm and women could now purchase commercial milk instead of wet nurses. Although lower rates of illness and disease was prevalent in babies who were exclusively breastfed (benefits of breastfeeding: another blog for another time), people were now lead to believe, and accepting, that failing to breastfeed was a common flaw of women's bodies and that they didn't have enough milk so their babies needed to be supplemented.
Politics continued to carry breastfeeding knowledge and support away from mothers. The late 1970's found Nestle and other artificial milk products being boycotted for commerciogenic malnutrition. This along with legal battles prompted the WHO and UNICEF to create the International Code of Marketing of Breastmilk Substitutes. Unfortunately Ronald Reagan was just elected as president and would undermine the Code before it was passed. US infant food companies lobbied Reagan to undo all the work that Americans had put into the Code and global child survival, and had his delegates vote against it at the World Health Assembly. In 1994 the USA signed up for the Code but has done little to implement it. If you'd like to read all of this in greater detail, pick up the book called "Why the Politics of Breastfeeding Matter".
Now, onto the REAL reasons that cause low milk supply and milk transfer issues. What classifies these things? Well, when a baby is not gaining enough weight for their age or are not wetting and soiling their diapers a certain amount a day, we know that there is an issue with milk transfer. If there is an issue with milk transfer, there will be an issue with milk supply because breasts respond to your baby's needs. In order for your breasts to continue making milk, they need to be regularly stimulated and emptied. So if your baby is transferring only small amounts of milk, your breasts will adjust how much to make and therefore your supply will decrease.
There are a few reasons for this happening. A baby must be latched properly to effectively feed. Having someone show you how to position and latch your baby when they are born is important for a successful start to your breastfeeding journey. Sometimes there can be anatomical issues in parent and baby that can make this difficult such as inverted or flat nipples, hypoplasia (insufficient glandular tissue), tongue tie, cleft palate and genetic disorders such as down syndrome. However, success in breastfeeding is not always determined by these challenges.
If you are concerned about your ability to breastfeed and want to prepare before your baby is born, seek out a local breastfeeding class or group, read books or make an appointment with a lactation professional. Gather information and tools to ease your mind about sufficient milk supply and your ability to feed your baby. It is in your nature. We are just finding our way back to owning it again.