Image of mother and the breastfeeding loop outlining the link between infant demand and a mother's supply.

Understanding milk supply and healthy growth

Evidence suggests that very few women are unable to breastfeed. Many other women choose either to stop prematurely or not breastfeed at all. Why?

Clearly, for some women, there are barriers to breastfeeding. But why is it that many women don’t begin breastfeeding at all, while others who commence breastfeeding either introduce infant formula to their breast feeding regimen (or cease breastfeeding all together) in the first few weeks following birth?

We know that the early cessation of breastfeeding can lead to feelings of guilt, sadness, and anger among new mothers, so let’s explore why this happens. What are the barriers to initiation and maintenance of exclusive breastfeeding, and how can society better support new mothers to achieve these things?

Some background

As background to this investigation, there are two important things we need to get our heads around:

  1. New mothers will produce enough milk for their baby to grow healthily. However, their ability to do this depends on not introducing other drinks or foods.

  2. A mother’s milk production is all about demand and supply. The more the baby suckles on the breasts, the more milk a mother will make. If the baby is fed formula or other liquids, the mother’s milk supply will decrease. It is therefore very important for a new mother to fully establish her milk supply, and this can take six weeks, before considering any supplemental feeds with formula.

Understanding the feedback loop between the amount a baby suckles at the breast and the amount of milk produced is important when you consider one of the key reasons women say they’ve reduced or ceased breastfeeding.

What are the issues?

When researching barriers to breastfeeding, we frequently hear that mothers believe that they ‘don’t make enough milk’ or have a ‘low milk supply’. This belief is often fuelled by misinterpreting the infant growth charts.

For example, some cultures believe that a heavier baby is a healthier baby. Our own research with Chinese immigrant families in Australia shows that family members may push parents to add infant formula to the baby’s diet if they feel the child is not growing quickly enough.

Many people believe that their child’s weight (or length, or both) should be crossing the percentile lines on the growth chart (see our diagram) as proof that their baby is healthy and doing well.

However, the ideal situation is for your baby’s weight and length to stay on about the same line as it has previously been, not heading up or down to the next line on the chart.

In this diagram, we see a baby whose weight was sitting around the 50th percentile until they were about three months old, then began to move upwards. The ideal would be for this baby’s weight to stay close to the 50th percentile line.

embed growth chart

What are the facts?

Contrary to what some may think, low milk supply if you’re not supplementing the feeding, is actually very unusual. In fact, it’s estimated that just five per cent of women do not produce enough milk for their baby’s needs.

As we’ve noted, providing infant formula in response to feeling you’re not producing enough milk is likely to reduce breastmilk supply further because your baby’s time at the breast will have been reduced. Introducing infant formula is not recommended.

What can I do?

If you or someone you know is concerned that they are not producing enough milk, it’s important to seek advice from your nurse or other carer as soon as possible.

That said, take comfort in knowing that there are many useful resources available to help you. For example, this Enough milk, too much milk, expressing video provides some great practical advice.

Your task

Take another look at the growth chart provided and consider the following questions before adding your thoughts in the comments.

  • Which percentile line on the growth chart does your child’s weight sit on. How do you feel about that?
  • What are your parent’s or parent-in-law’s opinion of your child’s weight, length and growth?
  • Do others in your life try to influence your feeding regimen because they are worried about your baby’s growth? Tell us about that.
  • Do you worry that you don’t produce enough breastmilk for your baby’s healthy growth?

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This article is from the free online course:

Infant Nutrition: from Breastfeeding to Baby's First Solids

Deakin University

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