As a lactation consultant, I have worked with moms who have breastfed their babies with only minor obstacles and who are mostly in need of reassurance and maybe a few adjustments here and there. I have worked with mothers who decided that breastfeeding just wasn’t for them, and I have supported their decisions because I believe that although breastfeeding has important benefits for moms and babies, it is ultimately up to the mother (and no one else) whether or not to do it.
I’ve worked with mothers with horror-movie level bleeding nipples. I’ve worked with babies who have had to have surgeries, who have spent significant time in the NICU, and learned to breastfeed months later (it is possible). I’ve worked with babies who have had multiple allergies, severe tongue ties, and developmental delays. I’ve worked with mothers who have breastfed through surgeries and medical conditions, and with mothers who have breastfed through postpartum depression and anxiety.
I would say that one of the most difficult things I’ve witnessed is mothers who desperately want to breastfeed, but who are unable to produce a full milk supply for their babies. There are so many reasons why a mother might have an inadequate supply of milk (and that would be an essay unto itself). And it’s especially complicated because it takes two to tango in breastfeeding, and sometimes there might be issues in a mom and a baby — and sometimes more than one issue at once.
The main factors I usually see that impact milk supply are hormonal factors in moms (thyroid issues and PCOS are some examples); moms who have had prior breast surgeries; or moms who never developed enough breast-milk-producing tissue in their breasts (this is a condition called insufficient glandular tissue and is more common than people realize). Issues in babies might be medical conditions like tongue tie, jaundice, or cleft palates.
And besides all that, in order for milk to be produced, a mom has to nurse or pump frequently enough to make enough milk (breastfeeding is a supply-and-demand system), and lots of moms don’t realize how very frequent that is at the beginning. It’s totally normal for newborns to breastfeed every hour or two (sometimes even more!), and moms who don’t get off to a good start with breastfeeding sometimes end up with what they perceive to be low milk supply, but which can usually be remedied with some good breastfeeding routines and management.
For any mom whose baby isn’t getting enough milk for whatever reason, I offer you rule No. 1 of breastfeeding: Feed the baby. I can’t stress this enough. Yes, get help in trying to increase your milk supply, but make sure you have a fed baby, whether that’s with pumped milk, donated breast milk, or formula. Ravenous babies do not breastfeed as well, and at the end of the day, what you want is a happy, healthy baby.
That said, I know how heartbreaking it can be to get to a point where you realize that your body may never produce a full milk supply for your baby. I have been in the room with mothers as they realize this. I have held their hands as they’ve wept, tears falling right down on their sweet babies’ heads. I have also seen the relief in a mother’s eyes when she realizes that there is a real reason why her body isn’t able to do this — that it’s not her fault, that she’s not doing anything wrong.
Some mothers in this situation end up giving up. Maybe the pain is too much for them to take. Maybe they are too busy or just not in a place in their lives to consider supplementing with donated milk or formula, while continuing to try to make breastfeeding work. Again, these reasons are complicated, private, and to be honored for what they are.
But I have seen mothers who have decided that they want to make breastfeeding work, despite the fact that they will never be able to do it with their breasts alone. And yes, it’s totally possible to do this. Basically, as long as you have nipples and a baby willing and able to suck, you’re in business.
I remember one mother I worked with who’d previously had breast reduction surgery. She had very little milk-making tissue and could only produce a few ounces of breast milk per day. But she was determined to breastfeed. She ended up pumping, using formula, and breastfeeding her daughter — mostly to soothe — for over a year. This kind of thing certainly isn’t for everyone, but if it’s something moms want to do, they should know that it’s an option and have the support to make it happen.
So here’s a special shout-out to the low milk supply mamas who are out their nursing their babies despite it all. And because pictures are worth more than a thousand words, I offer you some images of what breastfeeding with low milk supply can look like, from some Instagram mamas who are proudly breastfeeding with low milk supply every dang day.
Some moms are able to produce some or most of their baby’s milk supply and just need a few bottles of donated milk or formula to fill in the gaps. Many pump their own milk while they supplement with bottles. Others will use mostly bottles, but breastfeed in between for comfort and provide their baby with whatever milk they’ve got.
Others will use a supplemental nursing system, a thin tube connected to a bottle or bag of milk that gets attached to the nipple so the baby can breastfeed and receive their supplement at the same time (added bonus is they further stimulate a mom’s milk supply in the process).
And let’s not forget the mamas who donate their extra breast milk to babies who need it. This is an amazing gift. And holy crap, that’s a lot of pumped milk!
Breastfeeding can look all kinds of ways for all kind of moms and babies. But however it looks, moms are out their making it work, in their own ways, on their own terms, and that is just about the most badass, inspiring thing in the whole damn universe.