Pregnancy can be a time of great anticipation and preparation, but you can’t prepare for something you believe to be impossible. Have you heard the myth that every new mother can produce enough milk to exclusively breastfeed her newborn as long as she nurses on demand? The echoes and reverberations of this myth can be found in widely-read pregnancy books and in healthcare messaging to new and expectant mothers.
In fact, the reality regarding milk supply is far different. Moms can do everything right, yet for medical or anatomical reasons, they may not be able to breastfeed exclusively. This is known as chronic low milk supply (CLMS) or chronic lactation insufficiency (CLI). This inability to provide a baby with adequate nourishment from her body can feel devastating to a new mother. I felt crushed when I was diagnosed with CLMS after having been assured by my provider that every new mom can make enough milk. It turned out that I had several prominent risk factors for insufficient milk.
But nobody told me.
Beloved children’s television icon Fred Rogers understood that people—even the youngest among us—find knowledge of potential impending difficulty helpful, desired and necessary. Knowledge is empowering, and to be misinformed or have vital information withheld from a person is deeply disempowering.
Let’s start at the beginning. If you’re an expectant mother, it’s important to know that CLMS exists. Knowing the risk factors for CLMS will equip you with the information necessary to decide what steps, if any, you want to take. It will give you the gift of time—time to gather information, seek support and make informed decisions. If a new mother only learns about CLMS when she unexpectedly experiences it during the already delicate postpartum period, it can throw her into a psychological tailspin.
CLMS is an ages-old problem, according to lactation consultants. The risk factors are known and easy to identify: if an expectant mom is over the age of 35, she is at risk for CLMS. The same is true if she experienced no significant breast growth during pregnancy. Low milk supply is more common in first-time mothers.
Expectant mothers are also at risk if they have any of the following pre-existing conditions: polycystic ovary syndrome (PCOS), thyroid problems, diabetes or insulin resistance (IR), insufficient glandular tissue (IGT), breast surgery, cystic fibrosis or micronutrient deficiencies.
Portland is a city with a strong breastfeeding culture, and Oregon’s breastfeeding rates are among the highest in the nation, according to Oregon.gov. Women struggling with CLMS, however, may feel as if they inhabit the margins of Portland’s breastfeeding culture. Feelings of inadequacy and shame are not uncommon among this population.
Diving into the qualitative literature about the emotional experience of CLMS reveals several adjectives that pop up pretty consistently: “devastated,” “betrayed,” “confused,” “ashamed” and “depressed.”
If you are a mother currently experiencing CLMS after planning to breastfeed exclusively, please know that it is not your fault and you are not alone. In spite of this, you may feel overwhelming negative emotions. CLMS frequently takes a toll on maternal mental health. In fact, mothers with breastfeeding difficulties, including CLMS, are at an increased risk of depression and anxiety. When a new mother struggles with her mental health, this can negatively impact both the amount and quality of mother-infant interaction, and can undermine a mother’s relationship with her partner, placing strain on the entire family ecosystem.
Are you struggling to navigate the difficult and lonely problem of chronic low milk supply? You may benefit from mental health counseling or coaching. Group therapy is considered the gold standard treatment for problems that increase isolation, such as CLMS. It’s time we talk about chronic low milk supply openly.
Antonia Giedwoyn M.S.
Healing Hearts Counseling PDX
healingheartscounselingpdx.com
503.893.5965
Editor’s note: Wellness Word is an informational column which is not meant to replace a healthcare professional’s diagnosis, treatment or medication.