to ask you to STOP using these unhelpful phrases?

[StopCallingMeTeresa]

i apologise if this turns into an essay, but...

"Supply equals demand"
or
(worse) "low milk supply is actually quite rare so probably not your problem"

I've just read yet another MN thread where someone said the 2nd one (basically suggesting that a poster with suspected low milk supply probably wasn't in the "tiny tiny" %age of women who don't produce enough milk). It fucks me right off to keep reading this nonsense on here and other breastfeeding support groups/forums because it makes women feel like their actions or perception of low milk supply are the cause... rather than a genuine medical issue which might never be fixed. If a man had erectile dysfunction caused by a non-mental health issue, would we tell him that the problem wasn't a real problem if only he'd try the right thing, mentally?

Personally, this is (obviously) an upsetting issue. I'm 2 months PP and have low milk supply; as in, I produce about 5ml per 1hr pumping session, and I can get about 30ml on an entire day's worth of hours and hours of being hooked up to a pump inbetween breastfeeds.

My baby was delivered and within 48hrs lost so much weight he was admitted into NICU for monitoring. He was shrieking with hunger when he wasn't latched on, whcih was hours and hours of every day - i got about 3hrs of sleep in the first three days of his life, after which i was pretty much told he was in such a risky position we HAD to start supplementing with formula. My baby was literally starving.

• I'm on domperidone to increase milk supply (dr is talking about stopping it now as it has had no affect).
• I've spent every day of his life on a double hospital grade pump.
• Oatmeal breakfasts, flapjacks to inrease milk. I feel sick thinking about oats these days i'm so sick of them.
• I've taken fistfuls and handfuls of supplements every day: goat's rue to develop milk ducts, fenugreek, brewer's yeast, you name it, for 2 solid months.
• I've tackled slow let down by doing extreme skin to skin kangaroo style care the last few weeks; I listen to relaxing music whilst feeding and pumping, smelling my baby and looking at him/pictures of him.

His latch has been checked. No tongue tie.

• I've done about 4 feeding "resets" where I sat in bed and did nothing but skin to skin and feed for 3 days straight while my boyfriend and mum ran around doing everything else.
• i've had other stuff like bottle feed technique checked at my local LLL group, as well as the health visitor.
• GP has checked my thyroid and prolactin levels twice now - all normal.
• We've done a weighted feed at the local support group but i'm simply not producing anywhere near normal levels of breastmilk.

There's NOTHING i can do now to ever exclusively breastfeed as intended. i simply don't produce enough milk for some reason.

... and yet i keep reading on here especially that "low milk supply is rare" (no scientific source or attributation, of course!) and "supply=demand", just like all the other lies i was told at the antenatal group about breastfeeing.

can i ask you to consider the impact on women like me the next time you are writing something like that?

by washing over what is a genuinely distressing problem as if it weren't a real problem, it doesn't contribute towards good maternal mental health and suggests it can be fixed.

sometimes, it can't.

and now i'm trying to accept that it's ok. but then i read BF support threads on here with misleading / ambiguous phrases like that and i struggle.

@PlutocratCow yep, it’s frustrating as the research is so limited so far. I find it interesting that of the list of risk factors for low milk supply that Fed is Best provide, the vast majority would have either stopped a woman getting pregnant or her/the baby surviving birth in the not-too-distant past. I can tick off about a third of that list! fedisbest.org/resources-for-parents/know-risks-delayed-onset-full-breast-milk-supply/
I was told that hypernatraemic dehydration (which my baby had) is really really rare, yet it’s more than twice as likely to happen as SIDS, and all midwives/HVs seemed to be obsessed with avoiding that! journals.sagepub.com/doi/pdf/10.1177/0890334415613079

What I’d love to see is HCPs actively monitoring using these risk factors, weighted feeds, weighing at Day 3 and 5 and proactively jumping in to offer formula supplementation before babies become ill. At the moment there’s far too much emphasis on BFing always working and formula being totally unnecessary.

Why is “perceived” low supply an accusation. Some women have low supply for reasons that are not fixable. Some women worry that they have low supply when they don’t- or have low supply for reasons that are fixable. Both of the last two are “perceived” low supply.

More weighing and HV proactively offering formula is the last thing we need!! Over-thinking breastfeeding is not helping. Yes sometimes it's not working and support moving on is required. But a lot of the time it can work perfectly fine with the proper support and a bit of trust in nature (not to the extreme of course).

“What I’d love to see is HCPs actively monitoring using these risk factors, weighted feeds, weighing at Day 3 and 5 and proactively jumping in to offer formula supplementation before babies become ill. ”

Well, if you want to reduce the levels of breastfeeding and women’s confidence in their ability to feed their babies even lower, that strikes me as a good way to do it!

You've missed the bit about referring to the risk factors for low supply - those women in particular deserve to have much closer attention paid to baby weight and what is really going on with feeding, because they're at much higher risk of having low supply and/or delay.

So, what happened to us, was that we did get several people (all HCPs, some in person, some over the phone) urge us from days 3-5 to keep on going with 'cluster feeding', to deny that there was any problem and completely undermine what our gut instincts were saying as very new parents that our baby was starving. If our baby had been weighed on day 3 (we were actually still in hospital at that point - went home later that day. It would have been REALLY easy to weigh that day) they would have discovered that her weight was heading down rapidly, and could have implemented supplementing before she became ill. Instead, it was hospital policy not to weigh until day 5 (maybe to make their EBF figures look good?!), by which point she had lost >13% of her weight and was seriously ill. She had to be admitted to SCBU for four days and was tube fed formula as she was too weak to suck by then.

That's what happens when it's assumed that low supply doesn't happen, and that new parents are simply mistaking cluster feeding for the baby being starving.

So, how to distinguish between those mums and babies where there is a problem, and those who are just 'cluster feeding'? Surely it's better to err on the side of caution and check weight and avoid anyone becoming ill? Did you know that cluster feeding actually doesn't even occur at that point. It's what happens after milk has come in.
fedisbest.org/resources-for-parents/cluster-feeding-normal/

Research into breastmilk production in the first four weeks for term infants - how 'perceived' low milk supply actually does match up with actual low milk supply.
In comparison to the amounts given in the article, by day 5 I was barely producing any milk at all, by which point DD was seriously ill. She had at least 90% of the recommended amount of formula for her weight every day from day 5 to eight weeks old, when my milk suddenly increased in quantity and I could reduce the formula down.

I wasn't alone. Something similar happened to a friend, whose milk suddenly came in at six weeks, after she'd had to use almost entirely formula until that point. She then went on to EBF.

Neither of us had perceived low supply. We really did have low supply. Because of her experience I knew to keep trying, but I imagine a lot of women after a week or two of no more milk appearing decide they might as well give up on the BFing, as the view of formula destroying BFing is so pervasive.
drive.google.com/file/d/0B0_MbXCqYazzLWdTWE9xTXhhQkk/view?fbclid=IwAR1wdYEH5wR32HdK7ADf2fOpxl2HcU_Sx11PxykteL7UZGz1QgXxRDWzbxY

You might be interested in signing Infant Feeding Alliance's petition to end women experiencing shaming for infant feeding, whether it's BFing or using formula.
www.infantfeedingalliance.org.uk/2019/07/31/lets-end-infant-feeding-shaming-in-all-its-forms/

@StopCallingMeTeresa this was like reading my story when bubs was born. I paid for a private lactation consultant in the end and she told me I have hyperplastic breasts (they never developed properly when I was a teenager - cause trauma but what sort of trauma I’m not sure!) unfortunately the Midwives in hospital didn’t latch on to it even though I was in 2 weeks with bubs in nicu on a drip feed they just kept on repeating supply and demand etc. There needs to be more training for midwives in the subject their attitude towards it made me feel like an absolute failure

I also don’t think people should have to stop giving out advice because you don’t like it... as others have said, there are a number of reasons why people might say these things.

Just because you have a true low milk supply doesn't make it 'not rare'. It IS rare. Like it or not

I had... low milk supply!
I don’t talk about it much anymore for all these reasons, apparently it was all in my mind and just a perception and it’s very rare, so I probably was wrong and could have tried harder? Also shouldn’t talk about it as it might put another woman off trying to BF

This happened to my friend years ago her baby was admitted into hospital too. I dont think it's common but obviously does happen. She said she feels terrible about the fact she kept giving her boob when her child screamed, without realising that she was starving. I bottle fed both of mine. I wanted to see and know how much they drank.

Low milk supply is much more common than is touted by lots of midwives and lactation consultants. Expecting Better has a nice section about this if I remember correctly and Skeptical OB blog rages against a lot of this stuff regularly. I did my best to breastfeed my kids the first was great but refused to get off and the second one had a really bad late diagnosed tongue tie which I was refused help with. Eventually I found someone who would snip it but it was too late but he's healthy and happy and idgaf anyway, just making bottles in the night was a pain in the arse. Don't let anyone make you feel bad for not producing. I tried telling them with my second that I had no supply and I fed my first one great but was met with condescending advice.

Have you read Emily Oster’s Cribsheet - she analyses baby related studies and from what I remember def worth checking though as my memory is shot she suggests that the benefits you get from BF over formula are overplayed and peak within the first month. Not to say there aren’t positives with BF beyond that (eg ease of feeding etc) but her take is very different from eg the midwives/health visitors who put massive pressure on me to BF/not pump/not use nipple cream/not use nipple shields when my boobs were agonisingly cracked and back bleeding due to severe tongue tie (which they also totally downplayed).

Supply is tricky, I ran into problems (or thought I did) when I went on the mini pill and got my period at 3.5 months - really felt like a massive change in supply and was advised by HV to pump after every feed, got really exhausted and anxious and had to grit teeth while antenatal group idiots took the opportunity to go on about their oversupply/spurting boobs when they knew I was struggling... But a friend suggested that supply might be okay, to stop pumping and see. So at weaning stage (knowing she was getting extra nutrients from food) I ditched the pumping and for me it actually was okay and that helped my mood massively. So it is possible to panic unnecessarily.

I just wish women would be kinder and more thoughtful to each other. I feel similarly about my birth (induction then emergency c section) not least because my MIL sat in hospital telling me how much more ‘impressive’ her friend’s daughter was for having a natural birthing pool vaginal delivery - whereas I’d obviously copped out by having my stomach cut open to safely deliver a distressed baby . In fact all the messaging around natural births being best, from midwives to NCT to media, means any deviation makes us feel that we’ve failed WHEN WE HAVE GROWN AND DELIVERED A FUCKING BABY.

You’ve tried absolutely everything OP. Fed IS best. Look after yourself and enjoy your lovely baby

I think anybody that has done any meaningful research would agree that the headline benefits of breastfeeding are overstated. I say this as someone who would have loved to breastfeed exclusively (massive pph, I could only produce maybe 10 ml) it really does seem to be a wonderful thing if you can do it. I tried everything I could. So one more with genuine life threatening low supply over here!

YANBU. My baby didnt gain any weight in the first month of his life. Tongue tie snipped a few days after birth, milk came in on day 6. Midwives and HV were wanting him weighed every other day at one point. I was a FTM, stressed to the hilt that my baby wasn't "thriving" despite feeding seemingly 24/7. Accused by HV of ignoring feeding cues by giving a dummy.

Anyway, after 5 weeks I mentally couldn't do it anymore. Put him on formula and he piled on the pounds. Only then did my GP and a senior midwife tell me that during to losing 2 litres of blood and being severely anaemic my body was prioritising keeping my heart and lungs going at the expense of nice fatty breastmilk, and that I was so ill myself I was amazing for even trying to breastfeed at all!

Yanbu. You are doing your very best and it's clear how much love you have for babe which is the most important thing of all. I'm so sorry you're struggling, and I both believe you and support you.