Question

Case Study: Low Milk Supply

Mrs Thomas is a 24-year-old first time mother who comes in for evaluation of low milk supply. The 7-week-old baby had gained weight well until the last 2 weeks when the mother noticed less wet diapers and a decrease in the volume she was able to pump. Prior to this visit with you, she had been evaluated by a lactation consultant. At a visit 1 week ago, pre- and post-feeding weights showed low transfer of milk, but no nipple trauma. Her son now has a coordinated suck and swallow, asymmetric latch with a wide angle of the jaw. The mother holds the infant in a neutral position with the head slightly extended. The mother had been healthy prior to the pregnancy, had no pregnancy complications and had an unremarkable labor and delivery. Her breast exam was normal.

Note the mother’s concerns:

Assess these problems:

• What factors might contribute to the change in milk supply?

• How might you counsel this mother? Her family?

• What are some ways to help this mother increase her milk supply

Answer 1

The factors that might contribute to the change in milk supply;

·         Stress leading to anxiety may decrease production and reduced the milk ejection reflex);

·         Separation of mother and child ( due to return to work, school);

·         Hormonal imbalance (thyroid gland, polycystic ovary syndrome, diabetes type 1 or 2);

·         New pregnancy;

·         Insufficient breast tissue due to the tube-shaped breasts;

·         Surgery to the breast or nipple;

·         Mother who does not wake up due to factors such as (drugs, alcohol, medication);

·         Breast injury or wrong breastfeeding position;

·         Misuse of the teat leading to less efficient stimulation;

• Poor nutrition of the mother which is (less than 1500 calories per day).
• Baby refusing the breast due to; flat nipple, large nipple.
• Weak suction (premature baby, sick baby, trisomy 21)
• Short tongue frenulum.

We can counsel this mother and her family that the issue will be soon resolved and there is nothing to worry as anxiety will worsen the issue.

Some ways to help this mother increase her milk supply include; positioning the baby correctly, managing the nutrition of the mother, Staying hydrated, not forgetting the vitamins!.

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