Perception of insufficient milk supply

More than 40% of moms who have problems breastfeeding think they are not producing enough milk - and stop. Lactation consultations are proven to help.

It takes a certain level of confidence to breastfeed. A new mother needs to feel that she is able to supply her infant with enough milk to grow into a healthy baby. A lack of confidence, on the other hand, is linked to perception of insufficient milk supply (PIMS) - one of the most common reasons moms stop breastfeeding.

A lack of confidence can negatively affect how mothers interpret the signs that help prove that their baby is getting enough breast milk - including a healthy amount of dirty diapers, the steady growth of baby, episodes of baby being calmly alert, and that satisfied look babies get when they have finished breastfeeding.

Researching PIMS

To discover more about why new mothers develop PIMS - and to see if midwives and other healthcare professionals can make a difference - researchers carried out a study among new mothers in Australia's capital city of Perth.

They wanted to better understand which factors around birth and breastfeeding can lead to mothers to experience PIMS. So, for the first time, participants were questioned before their 1st lactation consultation - and during their 2nd consultation - to measure any differences in perception.

Key risk factors

The researchers discovered that first-time mothers had a greater chance of developing PIMS. It has already been established that these moms have a higher rate of quitting exclusive breastfeeding earlier on in their child's life. So it wasn't surprising to find that they were more likely to supplement their breastfeeding with formula, because of their perceived lack of milk.

The non-Caucasian mothers in this study also had higher rates of PIMS. The researchers pointed out that this could be due to their status as immigrants. Mothers who enjoy the support of their extended family tend to breastfeed longer. Without their extended family nearby, the immigrant mothers lacked this important support network.

New in this research is the discovery that PIMS was reported more often among women who had undergone non-elective caesarian section (compared to an elective caesarian).  And as discussed in the article, Breastfeeding and overweight moms, mothers with a high BMI also have a higher risk of PIMS.
 

It is interesting to note that physiological problems with breastfeeding and differences in the infant's gestational age, weight and length did not appear to lead to PIMS.

Lactation consultation

During their initial lactation consultation, the mothers were given specific instructions about baby's positioning and attachment. Other recommendations included feeding from both breasts, and feeding on demand (8-12 times a day). Breast compression during feeding and expressing after (or between) feedings was recommended. And if needed, the mom was given plenty of reassurance. 

The consultations turned out to make a real difference - with 46% of women changing their perceptions, and believing that they did produce sufficient milk. The biggest improvement was feeling that their baby "is well attached during breastfeeding". The perception that they needed to supplement breastfeeding with formula went down - from 70% to 49%. 

Boosting mom's confidence

Other issues needed more time and effort, including a PIMS mom's confidence that her baby was growing well, produced enough wet or soiled diapers, and looked satisfied after feeding. The researchers suggest that, after the negative experience of breastfeeding problems, mothers may need more time to become truly confident.

Thanks to the evidence collected, midwives and other healthcare professionals have more proof of the power of lactation consultations. By helping new mothers with PIMS - especially first-time moms - they can help improve the chances that these women will continue breastfeeding as long as they choose. And with confidence!