Sunday, May 9, 2010


The second biggest reason moms choose to formula-feed is not being able to tell if the baby is getting enough milk, according to the same article (Arora, 2000) that cited fathers' feelings as the biggest reason (see February's post on Dads).  "Mothers should be educated about assessing the adequacy of milk supply by listening for an audible swallow, noting urine production by the number of diapers changed per day, and by recording weight gain at well-child visits."  Easy enough?  Not really, even if you're informed.

Imagine: you are in your first week of trying to breastfeed your new baby. Of course, you can't see the milk, and you have yet to learn your baby's feeding cues. Your newborn, like many, is very sleepy, and often falls asleep at the breast, leaving you wondering whether he is full or just got tired of trying to extract nonexistent milk.  You are counting pee diapers; but premium diapers feel so dry--does that really count as a pee?  He screams for food 45 minutes after a feeding, causing you to question whether he got enough at the last feeding.   At his well-baby visit, he comes in at the 30th percentile for weight (based on averages of both breastfed AND formula-fed babies).  The pediatrician says it's fine, but you are definitely concerned now that he isn't getting enough milk.  In a moment of panic, you feed him some formula.  The formula brings you a sense of relief because now you are certain your baby is getting the calories he needs.  It's comforting to view and measure the feeds.  Formula supplementing becomes part of your routine.  Meanwhile, your body is adjusting its supply to the milk demanded by the baby.  Since the baby, sated by formula, demands less, your body makes less.  Concerned still, you supplement a little more.  Eventually, it begins to feel like nursing is just for comfort, and maybe, you stop.

It's a vicious cycle.  And maybe you never had a supply problem at all!  It is easy to understand how this can happen, given how powerful the need is for a new mother to nourish her baby.   Of course, supply problems can be and are real in many cases, but the treatment for low supply is more nursing, not less.  In yet another situation, the combo of support and information is the key: knowing the signs of a well-fed baby AND having someone there to coach you along saying, "He's eating well, and you're doing great."

Arora, S.; McJunkin, C.; Wehrer, J.; Kuhn, P. “Major Factors Influencing Breastfeeding Rates: Mother’s Perception of Father’s Attitude and Milk Supply.” From the Family Medicine Department and the Research Center, Hamot Medical Center, Erie, Pennsylvania. 2000.

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