When Mother’s Milk Doesn’t Flow

Photo of a woman who is breastfeeding a baby

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Lindsay Hall hoped to breastfeed her infant son for six months. She attended classes and did as much reading as possible prior to his delivery during the coronavirus pandemic. But no matter the preparation, Hall faced many unexpected hurdles and had to seek help.

Hall is not alone; many women expect breastfeeding to be a smooth, natural, formula-free process and then discover it is anything but smooth. And formula is needed.

Though the formula shortage that captured the news and crippled many families has abated, and the Food and Drug Administration continues to bolster supplies with the approval of specialty formulas from overseas, the benefits of breastfeeding continue to be highlighted.

According to the Centers for Disease Control, more than 83% of infants are breastfed in the United States and nearly 56% continue to be breastfed at six months of age. Nearly 25% of babies are breastfed exclusively through six months, while 19% receive formula supplementation within the first two days of life.

When Hall’s son was about 3½ weeks old, he became fussy during feeding, so she visited the Newborn Center of Charleston, an affiliate of Coastal Pediatric Associates, for guidance. Experts determined the baby had a dairy allergy. A heavy dairy eater, Hall relied on cheese cubes as a healthy snack, and her son’s little gut was inflamed.

“They really put me at ease about it and told me it’s very common,” Hall said. “They gave me a plan to keep trying to breastfeed.”

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This included replacing dairy with dairy-free snacks.

The Center’s staff shared the many feeding positions designed to help her baby latch and feed comfortably and successfully. Hall also learned that she had a clogged duct and mastitis that hampered the process, and that her breast pump was not the right size.

“Without the support from the Newborn Center, I think I probably would have been lost and given up,” she said. “They provided so much guidance and support, especially in the early days. You’re a sleep-deprived mom, trying to get your baby fed, happy and asleep.”

The Center’s ability to help mothers is about working with the needs and the comfort of the baby and the mother, explained Kimberly Kinkade, nurse practitioner and board-certified lactation consultant with the Center. Latching issues are common to many mothers like Hall, particularly if baby is not getting enough milk or the process causes pain for mom. Mothers are taught “the football hold” or upright positioning to help. Techniques such as breast compressions also can promote milk flow.

Past surgical histories and anatomy changes can present challenges for moms. Kinkade works with women to help stimulate milk production to override these issues. Stimulating milk production may also include extra pumping and extra feeding as well as herbal supplements, which are recommended in consultation with mom’s obstetrician.

The confidence Hall gained because of her partnership with the Center enabled her to continue breastfeeding exclusively for 4½ months; then, with formula supplementation, she breastfed until close to her six-month goal. Her dwindling milk supply impacted her ability to continue.

According Kinkade, many moms stop breastfeeding as a result of environmental pressures and stressors, often after returning to work.

“I do see a lot of moms who elect to cease their breastfeeding journey at that point, just because it becomes too much of a juggle for them to try to be a mom, be professional and make everybody happy,” she commented.

During a “return to work” visit, the Newborn Center staff helps moms develop a feeding plan that’s conducive to their schedule.

The Fair Labor Standards Act of 1938 requires employers with 50 or more employees to provide reasonable break time – uncompensated – with a place other than a restroom for women to express breast milk for up to a year after birth.

Laura Grant elicited guidance from the Newborn Center for all three of her children, especially with feeding her twin sons born two years ago. With her first baby, she breastfed exclusively for nine months but, with the twins, didn’t supplement until nearly a year.

The Newborn Center’s lactation consultant helped thwart issues with a blood blisters and painful latch with her first and with positioning and a feeding schedule for the twins – while she breastfed them simultaneously – as well as support for tracking feedings and pumping after her return to work.

“It’s mind-blowing to think that I was able to do that,” Grant reflected. “I think every mom that can breastfeed, even if it’s a couple of days or a couple years, it’s such a huge triumph. I think it’s amazing that our bodies can do that.”

Each breastfeeding journey is unique.

“The perfect plan is one that parents can implement and maintain while attaining their goals and have a happy, thriving baby,” Kinkade explained. “This is their personal journey, and it is our job to find that balance for them.”

By Linda L. Esterson

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