"Low milk supply" - why would this be?

[rubles]

I am writing this on behalf of a friend of mine who has a 4 week old. She introduced formula at 2 weeks because her dd was still 10 oz below her birth weight and she was told she wasn't producing enough milk.

I had always thought this was impossible because the body produced as much as required. She never had any problems with the latch, her nipples didn't hurt or crack, it was just that despite feeding all the time her dd didn't gain weight.

She said her boobs never became engorged when her milk came in - in fact she never noticed it, so that does sound strange.

Does anyone know about this? I would have thought it sounds like some sort of hormone deficiency, but shouldn't the doctor look into it?

TIA

The most likely reasons behind your friend's experience are these, rubles

1. Your friend was not feeding her baby often enough. Some mothers need very fequent feeds to build up and maintain a supply...feeding the baby more often should be the first response when there is a question mark about the weight. Feeding 'all the time' can mean a lot of things, including 'not feeding very often at all really'

1. Or - the baby was just doing fine and the weight was incorrect, or else simply represented the physiological norm for that baby

1. Or - the baby was not transferring milk effectively despite the lack of soreness and latch difficulty

It's not all that unusual for women not to notice milk coming in, in fact.

Giving formula will, of course, ensure she does not have enough milk, by creating the very situation it is intended to 'cure'.

Some reports indicate a link between conditions like PCOS and low milk, but hormonal reasons are the very least likely to be the cause of a poor milk supply.

But of course we'll never know, because some helpful person has told her she is not making enough milk and to introduce formula

my hv told me at 10 days to give my dd formula as she wasn't putting on weight fast enough. my gp was supportive and encouraged me to continue bf. at next weigh in dd had regained all birthweight plus a few oz. i am still bf at nearly 8months.
i feel that breastmilk is the best thing i can give dd, and i am so glad my gp told me to ignore hv.
i can't understand why there is so little support for bf from midwives/hv's and it makes me

and for your friend

I too barely notice the milk coming in - certainly don't get engorged. Never felt let-down, and have barely ever leaked (except in the early nights when boob2 leaked while boob1 was fed from).

I was in the same position as your friend, rubles, with ds mix-fed from 2w after coming under pressure from the midwife. With my second child I was determined to 'do better', and this time had fantastic support. Nonetheless it took me a long time to establish feeding, and, IIRC, dd took three weeks to regain her birth weight. I never felt that I had masses of milk, just enough to keep her going. For about a month before starting her on solids I would top her up last thing at night - with ebm when I had built up enough in the freezer, or with formula otherwise - as she was obviously hungry but I didn't think she was quite ready for solids. I dropped the top-up once she was happily onto solids and continued bfing her to 23m.

I don't think I'm a particularly prolific milk-producer (unlike my mum who had the classic shooting-across-the-room letdown, and expressed for premmies as she had so much). But, with help and support, can manage to feed my baby. Which was very reassuring after feeling so awful about being unable to do so for ds.

Your friend can still restart bfing - if she wants to. I kept offering breast at each feed, and at 6w started dropping bottles. I managed to get to about half-and-half breast and bottle, but it was hard work and she shouldn't feel pressurised into doing it unless it's really what she wants.

Quite. I did not feel able to do anything other than advise talking to a bf counsellor and mention that some women manage to relactate if they really want. It is very .

To be honest the baby did look quite thin when I saw her, and apart from pooing meconium did not poo until she had had her first formula feed - so if there is not PCOS then I think you are right Tiktok in that it could be (1) or (3) of your message. All she needed was some proper support and she could have pulled through.
I am so glad I had an Independent Midwife.

A baby not pooing since the first mec is waving a huge red flag saying 'I am not feeding effectively'.

It is poor practice to leave it 10 days.....there should have been a check on her bf to improve it by day 3 or 4.

But as we know, bf knowledge and support in the real world is often hopeless.....

I had a hundred mixed message when bfing dd, and did have to top up for the first few weeks, but was able to get back to 95% breast milk only by the time dd was about 5 or 6 weeks old. So it might be possible for your friend to do the same, if she really wants to, later on.

That said, there can be a genetic component in how much or little milk a woman produces, or produces easily - or so I've been told. And in my case, I never had much in one breast because of prior fibrocystic breast disease in that breast: the tissue just did'nt turn to milk-producing at all.

But I agree, support is crucial...and although I had loads of it, it was massively confusing and felt like bullying (in both directions) at times.

I've just stopped bfing my dd (various reasons) at 17 weeks, when she had her first weigh after she was born, the midwife's scales read that she had gone from 9lb birth weight to 8lb. I didn't get told to put her on fromula at all, midwife never mentioned it. Just told me to feed her more and check latch etc. It's a shame more people don't get the same support. It's very rare that a woman is incapable of producing the milk her baby needs.
Btw the midwifes scales were wrong feeding was going fine, my dd never lost an ounce of her birth weight! Midwife was very sorry and so was I for trying to force feed dd all day in fear that she would wither away!! lol

just thought i might add a snippet of interesting info, i was at breastfeeding conference last week in bolton and 1 speaker was talking about growth charts and how they should be set at the rate at which a bf baby gains weight (these are being brought in now). she said to consider how many different sets of scales a baby can be weighed upon. 1 - hospital at birth, 2 - midwife on home visit, 3 - health visitor at initial visit, 4 - HV clinic. who's to say that all those scales are weighing accurately?