All Mothers Have Milk …or Not?

All Mothers Have Milk …or Not?

 

All mothers have milk.

This statement triggers vehement discussions on the web, dividing those who claim that we are mammals and therefore breastfeeding is normal, natural and those who not having been able to breastfeed, feel judged for a supposed “non-commitment”.

But it is not just about commitment, although it does play a big role in it.

How are things really? Is it possible to “not have milk”?

The main causes of milk scarcity can be summarised, to simplify a very complex issue, in two categories:

 

Problems related to a failure in efficiently emptying the breast, which lead to the inhibition of milk production – These are at the heart of the vast majority of cases of milk shortage and failed breastfeeding.

These are problems related to breastfeeding management:

frequency and duration of feeding sessions, 

inadequate feedings, with an incorrect latch that does not allow a sufficient transfer of milk (difficulty of sucking on the part of the baby that is, a child who cannot suck effectively due to unidentified medical issues),

not allowing breastfeeding on demand (when the baby does not have the possibility to nurse as much and as often as he needs).

 

Problems related to the ability of milk production, therefore hormonal disorders in the mother (prolactin disorders, thyroid etc.), problems of mammary hypoplasia due to poor development of the breast tissue or problems of surgical interventions, accidents etc…

So, it is true that in a limited number of cases, the cause for low or lack of milk supply can derive from a reduced ability of the mother to produce, but surely the percentage of cases in which this occurs is extremely low.

Women themselves have low expectations of success in our cultural climate, and they easily believe in their own “flaws”

 

So why not say openly that “not all women can breastfeed”?

The problem with emphasising these situations too much, is that it becomes easy to create an alibi (“there was no milk”) even when to make breastfeeding fail are external factors that could easily be prevented,

such as errors in the way breastfeeding is managed,

such as not recognising an ineffective suction that does not sufficiently stimulate milk production,

such as separating mother and child during the first days,

such as wrongly suggesting the “supposed” lack of milk when the baby is agitated perhaps for completely different reasons ….

In short, it can become too easy to hide behind the statement that “it is not true that all women can breastfeed” to justify a lack of physiology knowledge or of good breastfeeding management.  Or a lack of prompt help and support.

Yes, in most cases, I believe it to be lack of education that causes the failure of many breastfeeding journeys.

Women themselves have low expectations of success in our cultural climate, and they are easily made to believe in their own “flaws” when there are difficulties, while it is very important to intervene to increase women’s confidence in knowing how to breastfeed, because it is self-confidence, one of the main factors of a successful breastfeeding journey.

 

On the other hand, there are indeed rare cases in which a woman, despite every well-directed effort, is unable to breastfeed: these are particularly delicate cases in which the professionals must know how to guide a mother.

It is not always possible to understand the cause, there are still many things that are not known about the hormonal mechanisms of milk production and therefore it is not always possible to understand what is happening.

In most of these difficult cases, you can make a commitment to at least improve things a little and have at least partial breastfeeding.

There are situations where the path to follow, is not always clear. And I think a good professional must be aware of all these possibilities, in order to manage different situations in the best possible way. In order to help a mother reformulate her goals based on her individual circumstance, to help her manage the feelings she may have, to in short, not to transform a difficult breastfeeding experience  into a failure of the mother-person, but to help her process the situation and get the best out of it – given the limits.

 

Basically “healthy” women can all breastfeed, and breastfeeding is a robust mechanism, so even problems caused by mismanagement can usually be recovered.

But if the mother has health problems that cannot be solved, or if the physiological mechanisms of breastfeeding are altered too much by external interventions, or if the child has a problem that is not identified, eventually breastfeeding may fail.

Breastfeeding professionals’ job must always be to help mothers prevent failures through correct information and practical help to solve problems. But they must also help them find their way, whichever that might be.  And when things really do not go as planned, help them manage pain and disappointment, helping them to live the experience without leaving an open wound behind.

I believe this to be, a part of the professionals’ job that must never be forgotten.

<S.G>

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