Yesterday we offered you an entry in which we explained one of the greatest myths of breast milk, the one that speaks of hypogalactia or lack of milk production.
Accustomed all to see children who take a bottle making shots every three hours, including our mothers and many professionals, it is surprising to see that many (practically all) breastfed babies do not respect these schedules and ask to breastfeed more often. Given this rate many people think that the cause is that the child goes hungry and that the mother does not have enough milk.
This is not always false, but most of the time. In fact, sometimes the baby is not gaining weight and even loses and the mother has milk almost to overflow, being then a problem of suction, position or sublingual frenulum that makes it difficult to extract milk.
Today we continue with yesterday's entry showing what are the possible causes of true hypogalactia and what are the feelings that make a mother think that she is not producing enough milk.
Possible causes of hypogalactia
- Hypothyroidism: when a woman has hypothyroidism not diagnosed milk production is very low. At the time the diagnosis is made and milk production is treated, it is not affected.
- Placental retention: the moment the placenta is expelled is the starting gun so that milk starts to be produced. At that time the estrogen level drops allowing prolactin to start creating milk. If, unfortunately, a part of the placenta remains inside the uterus, the hormonal "revolution" does not happen and the milk is not produced in the necessary amount (hypogalactia).
- Agenesis of breast tissue: the woman's mammary glands have not developed normally during pregnancy. It is a condition with a very low incidence that makes production low.
- Surgery: surgery can cause milk production to be affected. It usually depends on the type of surgery performed. If the nipple has been lifted, the ducts are reconnected and although the first child may not be able to breastfeed, mixed breastfeeding can usually be done with a second child and exclusive with a third.
- Syndrome of Sheehan: is the necrosis of the pituitary gland or part of it due to lack of blood supply during childbirth, usually because the woman has lost a lot of blood. When no prolactin or oxytocin is produced (of which the pituitary gland is responsible), milk cannot be created.
- Congenital prolactin deficit: if there is a deficit of prolactin, the hormone responsible for creating milk, the mother will make less milk than necessary. It is also a strange syndrome that happens rarely.
Possible causes of hypogalactia sensation
After seeing the true causes of hypogalactia, we need to see the causes of feeling of hypogalactia, which are the culprits of most hypogalactias verbalized by mothers.
- The child do not pump properly: the mother has milk, but I have put it on this list because the result is the same, a child who fattens little or nothing, who cries or sleeps a lot and is not eating enough. These are position problems, suction problems with culprits such as retrognathies (lower jaw too small) or hookworm (sublingual braces that do not let the tongue milk the mother's breast). Here the mother thinks she has no milk, but the problem is not that.
- The child sucks very often: breastfeeding is done on demand, so it is normal for children to breastfeed often, although many women believe they should eat, more or less, every three hours or more. However, when a child is not eating enough it is also logical to ask for food very often. It is necessary then to see the child's weight and look for other possible problems that lead us to the previous point.
- When he is not breastfeeding he is nervous: children who are eating little usually complain between shots because they are hungry. However, not always that a baby complains is hungry and sometimes, even when they are satisfied, they want to be close to mom or dad and request that contact with groans and perhaps with tears. Although less and less happens, there are still people who do not contemplate the need for affection as a real need (“if you have eaten, you are not cold or hot, I have changed your diaper and you are not sleepy: what are you complaining about?”) .
- Mother has soft breasts: Many mothers do not notice the rise of milk, many always notice it between shots and some notice it at night or when their baby spends a long time without breastfeeding. Of all of them the ones that get more nervous, obviously, are the first, because they do not perceive any sensation that makes them think that there is milk in their breasts. In this situation, any minimal gesture that the baby makes, any discomfort or sign will surely be the fault of "I don't make enough milk" ("I suck a lot ... I don't have milk", "I suck a little ... I don't have milk", "I cry a lot ... because I don't have milk ”,“ cries little… since he doesn't eat he doesn't have the strength to cry ”, etc.).
- Etc .: There are many other causes, from inheritance in the style "my mother had no milk, I do not have either", which are not true, going through "with the first I did not have, so I do not even try", until "I notice very soft breasts so I don't have "or" is that I have a small breast ". All these causes are myths too, but they make the mother fall into absolute distrust, the result of which any symptom (or belief that there is a symptom) of her son will be blamed on the lack of milk.
What to do before a theoretical hypogalactia
Once you have seen the possible causes of hypogalactia (true and not true) it is necessary to know what can a professional or someone who is trying to help a mother do with these feelings?.
There are no miraculous solutions, so ideally try to diagnose in the most concrete way possible the cause of the child is eating little or reveal the reason why the mother believes that the child is eating little. Ideally, first make an interview with the mother or just let her talk so that she tells the “symptoms”, the sensations, what she notices, what she would like to notice, if it hurts, if it does not hurt, etc.
Then it would be necessary to make an assessment of both the woman's chest and the child's mouth, looking for some reason that can cause difficulty, and an assessment of mother and child together, how they position themselves, how the baby sucks, if the suction is effective , etc. Obviously, knowing that hormones play an important role, a doctor should ask for a blood test in which one could see if there is an undiagnosed hypothyroidism or even if the mother has too low prolactin and that is why she is not producing enough milk.
After all this there are always other variables that can and should be assessed, often difficult to find. Me personally, when I am not able to find the cause I just "pulling" known lactation consultants, of those who have half a life "seeing boobs", because the devil knows more by old than by devil, and they have a clinical eye that I would want for me.
With all this I want to show that "well if you don't have milk, give it a bottle" is the most comfortable solution that a professional can take, as simple as verbalizing it. Even my father, who has not studied any medicine or has any idea of breastfeeding, can give that advice. Even I can give it… but of course, it would not be fair for those mothers who want to continue breastfeeding, because I would not be doing my best for them, as the health personnel are presupposed.
Photos | moppet65535, Daquella way on Flickr
In Babies and more | Myths of breast milk: "This child goes hungry, I would say that you have no milk" (I), "I do not have enough milk", Myths about breastfeeding: for a woman to have enough milk she must drink plenty of water, When the baby rejects breast (I) and (II), why very few babies take exclusive breastfeeding up to six months
