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Infant feeding

New study suggests insulin affects milk production - what do we think?

27 replies

DespicableYou · 06/07/2013 21:07

for the brief link - am on my phone so can't google this properly... link here

I feel I should declare my interest here - after delivering dc1 who was nearly 10 pounds I struggled to b/f and she lost 20 per cent birthweight in 7 days.

I b/f her for 6 months with one bottle of formula at lunch and one at bedtime.

She fed constantly, was always hungry and grouchy and rvery bit of support and advice I got from mn/kellymom/nct said that low milk supply was either a myth or very rare.

What if its not?

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tiktok · 06/07/2013 21:46

Despicable, it's not a study, it's a proposal for a study to test a hypothesis. We're gonna have to wait a while before anything emerges from it.

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DespicableYou · 06/07/2013 21:54

So what do you think, tik tok? What's your gut insinct? You have a lot of experience, right?

Anecdotally, can you say if it's possiblecthat (despite good latch etc) some breasts just produce less milk than others?

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hazeyjane · 06/07/2013 21:59

Would this tie in with the theory that pcos can be a cause of low milk supply? Women with pcos also having problems with insulin resistance.

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MrsMargoLeadbetter · 06/07/2013 22:07

Interesting link. I struggled to bf DS, similar to you OP he was always hungry after I'd fed him.

I am now mixed feeding DD but similar issues.

I have PCOS which could be linked to insulin resistance. I also tick the other markers.

I do think that some breasts produce less milk based on my experience. However I am no scientist/healthcare professional etc.

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MrsMargoLeadbetter · 06/07/2013 22:08

Xpost with hazey

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tiktok · 06/07/2013 22:22

Of course some mothers produce more breastmillk than others.

It's a continuum.

It is massively affected by externals - circumstances surrounding the birth, the early days, whether women are able/willing to offer the breast a lot, the ability of the baby to stimulate good production.

I don't have a gut instinct about any of this - I look at the science of it :)

Some women with 'imperfect' circumstances will produce just fine, and their babies will thrive. Other mothers may find the 'imperfect' circumstances are too great to overcome.

There's a lot we don't know and it's good to find out more. If we got postnatal circumstances sorted out better, with more support and genuine help for mothers, we'd find mothers would have more milk and would not stop bf because they think that a baby who needs a lot of care, closeness and frequent feeding is indicating breastfeeding is not going to work for them (see threads on mumsnet passim.....)

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iwouldgoouttonight · 06/07/2013 22:22

It'd be interesting to find out if there is a link. I have PCOS too. I managed to feed DS for 6 weeks and he was always hungry twenty minutes after feeding, I switched to formula because I was simply exhausted. When I stopped BFing I didn't get engorged, my breasts just went back to normal, so i'm convinced I wasn't producing enough milk. With DD I asked for more support because I really wanted to try BFing again but she was admitted to hospital after five days because she had lost so much weight and was dehydrated. Sad I spent hours connected to a machine to express for her and only managed to produce about 10ml.

I think my boobs don't make much milk!

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ifindoubtnamechange · 07/07/2013 08:29

Will be interesting to see the outcome of the study.

I am diabetic and my issue was oversupply. I felt like I had two milk fountains instead of breasts.

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Fluffeh · 07/07/2013 09:49

iwould your experience with your DD is almost the same as mine. At day 3 they force fed my baby 50ml top ups every 2 hours. She had no urge to bf with that amount.
No matter how much I offered.
I have pcos and I take metformin for the insulin resistance. I offer my baby the breast constantly but I still don't make enough milk. I'm now using SNS in the hope of stimulating more milk instead of bottle top ups.
I never stopped trying to ebf my baby. She is 11 weeks old tomorrow and apart from the forced top ups in the early days, all I have done is ask for help and breastfeed as much as possible. Yet I still can't make enough milk.
There isn't a supplement or technique I haven't tried. I don't want to feed her formula but if I didn't top her up she would starve :(.

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FreeButtonBee · 07/07/2013 20:59

If we're sharing anecdotes, I have PCOS, conceived with Clomid and ended up with twins! Both were TT and the first 12 weeks of BFing were very very difficult with mammoth cluster feeding from both which incldued alot of screaming, bobbing on and off and on and off and more screaming! It took DTS a month to regain his birth weight. But I am still feeding them both at 5 months and they sometimes even sleep through!

I think I did struggle to get my supply up (had a section and my milk didn't really come in til day 5 and DTS in partic was topped up a lot until his tongue was snipped) but was able to overcome the 'imperfect start' really by sheer stubbornness (if I had a pound for everyone who said ooh, you can't breastfeed twins!) and reading mumsnet and kellymom over and over and over - often the same info night after night after night. Don't know what was down to PCOS or what was down to twins/section etc though obviously

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DespicableYou · 07/07/2013 21:59

What interests me, is the received wisdom that poor milk supply can pretty much be overcome by the right support...

What about those of us who take our babies to bed with us/feed constantly/research and imbibe galactalogues/get our latch checked (repeatedly)/have tongue ties checked (and snipped) and STILL have hungry babies who lose weight.

Isn't it possible that there is something going on there, biologically, that simply means we don't produce much milk, no matter how hard we try?

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tiktok · 07/07/2013 22:23

No one who understands about bf would claim there is no such thing as a physiologically low supply - it's mad to say support is always the answer to everything. If anyone says this, they're being a ad over-confident. But support (including knowledgable support) is essential, and it's often lacking.

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tiktok · 07/07/2013 22:24

ad=tad

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DespicableYou · 07/07/2013 22:36

Thanks tiktok. It means a lot that you've said that.

I'm going to bookmark this thread.

Next time someone posts a thread about how frustrating it is that women claim they didn't have enough milk to breastfeed successfully, when really they just didn't try hard enough I'm going to quote you Smile

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notcitrus · 07/07/2013 23:02

As another anecdote, I have PCOS, needed Clomid to conceive both times, but produced loads of milk - when dcs were 2-6 weeks old, my main problem was not squirting anyone within 6 feet. And the pain of sorting latch out, esp with ds, and thrush with him...
Finally got sorted, but it was a shame I was too coordinated to collect the excess.

I used to be a biologist and worked on a gene that turned out to be required for breast milk production - mice without it were fine until after the mothers gave birth, produced a bit of milk, but only enough for a couple pups; most starved - until being given foster mothers. There was a whole pathway of genes being needed to switch on in late pregnancy to boost action of the next to damp down a third to boost a fourth to make more of the proteins in milk... some parts could be possibly boosted by more suckling, but other inputs probably not. My pet gene, when overactive, was associated with nasty breast cancers, so if it was underactive, one wouldn't be able to bf but would be at lower risk of those cancers. Though hard to tell how important that is given that most genes can be involved in causing or protecting against cancer... the Mail is right sometimes!

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edam · 07/07/2013 23:13

Despicable - I don't think anyone other than a dunderhead would say women who want to b/f but struggle are 'just not trying hard enough'. I think the lack of supply thing is often a result of health professionals not providing enough support or the right support or information. E.g. health professionals leading women to believe you can measure supply by how much you can express, which I gather is rubbish. (No doubt Tiktok will correct me if things have moved on since I was b/f my own ds.)

MN threads contain a massive and depressing collection of comments and actions by health professionals who know f-all about b/f but spout as if they are experts. I know it was midwives on the antenatal ward who screwed up my sister's attempts to b/f, bullying her to do it while simultaneously doing everything they could to make it fail. Incredibly cruel and even Kafka-esque. If they wanted her to b/f, they could have allowed her to spend some time with her baby, instead of having her on a schedule that was so busy her feet swelled up because she never got the chance to sit down!

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Splatt34 · 08/07/2013 08:09

I think there may be something in this. I did everything, & I mean everything to ebf DD1, but at 6 weeks she had only gained 5oz from birth. She look ill in the photos. Added in formula top ups and gained 21oz in 6 days and became a happy baby.

I was gutted when at 2 weeks DD2 was done to 8lb 3 from 8lb 15 born. I had stayed in bed skin to skin the first few days, despite toddler, had been to feeding clinic 3 times check latch and tongue tie. Started 2 x 3 oz formula, gains 8oz in a week. She's 5 weeks now and combo feeding well.

I either have low supply or am making a skimmed milk ;-)
It is very upsetting when the answers to this are always "see a counsellor" "get the latch check" "id there tongue tie" "feed more" "skin to skin" when you have already done all this, & taken fenugreek & domprridone. I particularly would like the woman who did our nct bf session 3 years ago to know this as she absolutely refused to acknowledge that anyone might struggle or not be able to ebf. Way to make a new mum girl a complete failure.

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tiktok · 08/07/2013 09:52

Splatt, I hope your memory of the NCT counsellor refusing to believe anyone would struggle with bf is skewed - breastfeeding counsellors' whole raison d'etre is that women struggle. If they didn't, what would be the point of being a breastfeeding counsellor? We'd have no 'customers'!

I am often asked in an NCT class something like 'but some mothers just can't breastfeed, can they?' and I might hear a brief account of something that really does not illustrate that at all eg 'cos my mother says I preferred the bottle after 2 days' or 'I'm a twin and obviously she couldnt feed us both'....and I can't really go into the details to say why those stories might not be the whole of the narrative. Maybe I end up sounding dismissive and disbelieving, and I don't mean to.

And you are breastfeeding - you are struggling (for probably many reasons - there are hardly any simple stories!) but you are making milk.

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tiktok · 08/07/2013 10:02

Just to add - I am aware that women struggle with bf for reasons other than supply so we'd still get calls about other stuff!

About half of all counselling calls and encounters between NCT bfcs and mothers are to do with 'is my milk enough/have I got enough/I worry I won't make enough/is the quality ok/help me make more milk.....etc etc.

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DespicableYou · 08/07/2013 13:32

" I don't think anyone other than a dunderhead would say women who want to b/f but struggle are 'just not trying hard enough'. I think the lack of supply thing is often a result of health professionals not providing enough support or the right support or information."

The question isn't about support, though. It's - is it possible that some women may not produce enough milk no matter how much good support and information they have.

I do feel a little like you're deliberately avoiding the issue raised in the thread, Edam, by bringing it back to support. Or, do you genuinely not believe that low milk supply can be a physiological issue, as opposed to a practical one (correct technique etc)?

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DespicableYou · 08/07/2013 13:34

notcitrus - that's really interesting.

Thanks as well to those who have shared their experiences on this thread.

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midori1999 · 08/07/2013 16:47

despicable, I don't think anyone sane has ever questioned whether it's possible that some women will not be able to produce enough milk regardless of what help and support they get, we know that some cannot. However, women who truly cannot produce enough milk are rare and it is more common to see perceived lack of supply or lack of supply which is caused by fixable problems.

Whether insulin resistance/diabetes can cause supply issues remains to be seen. It's certainly not my own experience though. I also wonder how helpful it is for women to go into breastfeeding thinking they may well have problems because of x, whatever x may be in their case(diabetes, thyroid, breast surgery etc) as it's possible that problems they have may be put down to that when they are fixable.

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DespicableYou · 08/07/2013 17:13

"women who truly cannot produce enough milk are rare"

Can you provide some stats or research to evidence that please? I'm not saying it's not been proven, but I'd like to see what it is that makes you assert that so confidently.

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Splatt34 · 08/07/2013 18:10

TikToc - you have responded to me several times for both my babies for which I have been very greatful. But yes 3 years ago we sat through an antenatal class where we were told that people who had problems with bf weren't really trying. She refused to offer any advise about what to do if it wasn't working because "it will if you really want it to". Cue my husband's response of "breast feeding nazis!"

Having had history literally repeat itself health visitor, bf counsellor and mw all think I have low supply, & I have a hospital with daily drop in clinic & awards for their bf support.

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tiktok · 09/07/2013 08:08

Splatt, she should not have said that - poor show :(

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