Causes of perception of insufficient milk supply in Western Australian mothers

Abstract

A perception of insufficient milk supply (PIMS) is associated with early discontinuation of breastfeeding. Ideally, an objective measure of milk supply would either dispel or confirm this perception and provide reassurance or guide professional advice. Clinical signs of sufficient milk intake (steady growth, sufficient elimination, infant alertness and breasts feeling full before breastfeeds and soft after breastfeeds) should provide confidence in milk supply. We surveyed 423 mothers in early lactation who had breastfeeding problems to determine the proportion that had PIMS and to determine if the mothers with PIMS relied on these clinical signs or other perceptions of their infants' behaviour as indications of insufficient milk supply. By 3 weeks after birth, we found that the rate of PIMS among mothers with breastfeeding problems was 44%. Supplementary infant formula was being given to 66% of the infants, so the clinical indications were that milk intake was sufficient, but 74% of the mothers with PIMS cited concerns that their infants did not appear satisfied after breastfeeds. After targeted advice from lactation consultants, mothers with PIMS showed positive changes in their perceptions of their milk supply, underlining the value of professional guidance soon after birth. We conclude that an appearance of infant dissatisfaction is the major cause of PIMS in Western Australia.

Wellbeing of Breastfeeding Women in Australia and New Zealand during the COVID-19 Pandemic: A Cross-Sectional Study

“…Despite experiencing various problems and recent challenges associated with breastfeeding, 82% of participants were exclusively breastfeeding, suggesting the pandemic did not negatively affect breastfeeding in our study population. Instead, incidence and types of breastfeeding problems experienced were consistent with those reported prior to the pandemic [44][45][46][47][48]. Around one-fifth of participants shared commonly reported breastfeeding problems, such as sore/damaged nipples and attachment difficulties.…”

“…While infants of younger age and mothers that perceived their infants' sleep as "a small problem" were more likely to be exclusively breastfeeding, it is possible that these factors interrelated as durations of consolidated infant sleep increase significantly between one and four months of age [52], and many dyads change from full to partial breastfeeding from around four months [53]. Despite our sample's high rate of exclusive breastfeeding, our findings support the need for accessible professional lactation assistance during the pandemic [44], with special consideration given to women that have been pregnant for longer periods of the pandemic and those with perceived low supply.…”

“…Perceived low milk supply is known to negatively influence breastfeeding self-efficacy and duration [49][50][51]. In a recent Australian cohort [44] assessing breastfeeding problems after birth, up to 44% of women reported low milk supply. After receiving advice from a lactation consultant, women generally showed positive changes to their supply perception.…”

Breastfeeding and breastmilk substitute use and feeding motivations among mothers in Bandung City, Indonesia

“…Many women also cited perceived insufficient breastmilk as a reason for feeding their children BMS. Lack of knowledge, confidence and self-efficacy have been widely reported as reasons among mothers for less than optimum breastfeeding duration (GAIN, 2013;Thulier & Mercer, 2009), and perceptions of insufficient milk are commonly cited for early introduction of complementary feeding or not breast-feeding exclusively (Bunik et al, 2010;Kent et al, 2020) including in Indonesia (GAIN, 2013;Nuzrina et al, 2016;Roshita et al, 2013). Women's perception of milk insufficiency may stem from anxiety about her own nutritional status or meeting her infant's nutritional needs and infant satiety, advice from and role modelling of family members about mixed feeding, insufficient support from the health system and perceived infant feeding norms (GAIN, 2013;Safon et al, 2017;Susiloretni et al, 2015).…”

The Intervention of Maternal Nutrition Literacy Has the Potential to Prevent Childhood Stunting: Randomized Control Trials

“…In addition to this, about 74 % were worried that their infants are not really happy after breastfeeding. 7 The current gap in the scientific evidence shows the effect of maternal nutritional literacy on the coping mechanism of child nutrition, especially in the era of the COVID-19 pandemic. An experimental MNL intervention study is needed to answer the hypothesis, which can be used to prevent the direct effect of the COVID-19 pandemic on stunted children within the first 1000 days after birth.…”