Concerns around low milk supply, whether due to perception or reality, can be distressing. It can seriously affect a breastfeeding mother’s confidence, especially during those early days, weeks and months of adapting to life with a new baby. Perceived insufficient milk supply (PIMS) is when a mother believes she is not making enough breast milk to adequately feed her baby. Sometimes, the mother does actually have a low supply of breast milk, but more often, her supply is adequate or simply needs a little boost.
It’s so important for mums to:
- have access to effective support to recognise normal breastfeeding patterns
- understand her child’s developmental stages that may affect her supply or her child’s unsettled behaviour
- get help to correct any issues with milk transfer
- and be provided with advice on adjusting milk production if required
According to the World Health Organisation (WHO) and the Australian Breastfeeding Association, it is recommended that babies are exclusively breastfed for their first six months of life, continuing breastfeeding with complementary foods until two years of age or beyond – for as long as the mother and child want to continue.
Despite advocacy attempts however, breastfeeding rates worldwide are relatively low. Although a high proportion of mothers initiate breastfeeding, this figure drops off significantly by six months. WHO statistics show that globally 3 in 5 babies are not breastfed within the first hour of life and nearly 2 out of 3 babies globally are not breastfed exclusively up to 6 months of age. Australian National Infant Feeding Survey statistics showed that in children aged 0 to 24 months in Australia in 2010, 90% initiated exclusive breastfeeding, but only 15.4% of babies were exclusively breastfed to 5 months (that is, for less than 6 months).
While there are many causes for unsuccessful breastfeeding, according to statistics, an inadequate breast milk supply is the most common self-perceived reason for supplementing with formula. The early introduction of infant formula may then result in a decrease in a mother’s milk production, causing them to discontinue breastfeeding altogether.
What makes a mother think she has a low milk supply?
Often, women may believe that their milk supply is low when it actually isn’t. This perception of low milk supply can occur if a mum misinterprets normal newborn behaviour; for example, frequent feeding in newborns, cluster feeding and growth spurts. A mother may also not know that her baby’s swallowing pattern can change in response to the fat content of her breastmilk rising, that her breasts may start to feel softer as weeks go by, or that the amount of milk she can pump is not an accurate measure of how much a baby can get directly from the breast. Instead of assessing the frequency of wet nappies and stools, a mum may perceive infant satiety cues, fussing at the breast or excessive crying as more important indicators of insufficient milk supply.
As breast milk is digested quickly (usually in 1.5-2 hours), frequent feeding is completely normal for breastfed babies. This seemingly constant contact with mum also makes babies feel secure – and it is simply impossible to spoil a baby by meeting their needs. It’s also normal for babies to feed more frequently and to be fussier at night-time. As a woman’s milk supply adjusts to her baby’s needs, her breasts may feel softer and may not leak milk like they did previously. Babies also get more efficient at extracting milk as they get older, so may not nurse for as long as they previously did. Of course, during growth spurts, a baby may suddenly increase the frequency and/or length of nursing, which increases milk supply to meet their demand.
In rare cases, where a mum has a primary issue with lactation, specialist help may be required to investigate any underlying issues, so it is important to seek advice and guidance.