Susan strikes a blow for listening to mothers, and taking seriously what
they say.  Karleen notes that one mother in three in Australia will stop
breastfeeding because she perceives her supply to be low.  I take it for
granted that it is only called perceived low supply if the supply is
actually normal, but mother perceives it to be abnormally low.  One common
way this happens is when mothers read things in parenting guides like 'in
the beginning, babies feed seven or eight times a day (every three hours)
but after some weeks they go down to about 6 times a day (every four hours)
and later, they may breastfeed four times a day.'  
If her baby is feeding ten times a day, no matter how contented the baby,
how exemplary the growth and development, nor how convenient the whole setup
is for the family, guides like these can plant the seed of doubt.  'She must
not be getting enough since it is only lasting one or two hours at most, she
must need higher volume each time so she can have the expected number of
feeds in a day.'
I know this perception and we have been battling with it for ages.  
Or, mothers will call around 8 weeks postpartum, convinced that their milk
is gone because their breasts have gone all soft again.  This concern occurs
even in the absence of any sign of discontent in the baby, and any sign of
change in growth rate.  
So when I see the words 'perceived low supply' I am not thinking of the
mother whose baby's growth has been faltering for weeks, while baby has gone
from robustly unhappy to meek and quiet and sleeping a lot, and the
well-baby center is saying 'it's fine not to be at the top of the weight
chart', or 'bring him back in a week and we'll weigh him again (and meantime
we won't lift a finger to find out what could be causing the whole sorry
mess)' even when it should be blatantly obvious to the most casual observer
that the baby is not at all happy.  That is low supply, not a mistaken
notion that supply is low.
When I had my first child, the commercial guidebooks said things like
'breastfeeding is best, but when your baby starts showing signs of needing
more (frequent feeds in evenings, having achieved a weight in the range of
ten pounds to ten pounds, one ounce, not sleeping at least eight hours a
night at eight weeks, or simnply being 4 months old) then it's time for our
iron-fortified cereal!'  So, under this paradigm, if the baby is not gaining
fast enough, then you don't have enough milk, and if the baby is gaining
well, you won't have enough because the baby's growth will surely outpace
your ability to produce milk.
I have never brushed off a woman who contacted me with concerns about
supply, and the first thing I do is try to find out the basis for the
mother's concern.  Then we take it from there.
Rachel Myr
Suffering perceived sleepiness in 
Kristiansand, Norway

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