Dear all:

I know that the research says that perceived low milk supply is the biggest reason for 
women quitting, but I think the main reason is lack of empathetic support.

I find perceived and actual low milk supply easier than persistant pain in terms of helping 
a mother to continue. The trick is to empathetically explore mom's fears, determine 
whether they have a basis or not, and help her to either increase the supply to a higher 
level, or come to terms with less than perfect.  I have worked with mothers with a 25% 
milk supply who've kept it up for an entire year.  

What I find is that moms with actual low supply, or perceived low supply, are often told 
"well, why bother if you're not making enough".  And there are a lot of reasons why they 
should bother that they are never give. 

Another reason why they give up is if they actually have drifted into low supply because 
they never had their perceptions explored and they are told they must not supplement.  
Once the supply has dropped, this kind of advice can be deadly because the baby is no 
longer capable of driving up the supply that dropped down and they then get the negative 
psychological feedback of the screaming unhappy baby.  

I do not use a cookie cutter approach with these situations.  I always try to listen 
carefully about what mothers are REALLY telling me, which may not be so transparent.  
And sometimes, I find a more moderated approach (perhaps not 100% breast milk) will 
actually keep these moms going rather than giving up entirely.

Finally, having caught more than a few cases of low milk supply where the mom was told 
she was doing fine and wasn't --- the worst was a case of hypoplasia of one breast that 
was among the most severe I have ever seen, but her ob and the other groups she had 
attended told her to keep pumping on that breast and never told her about the hypoplasia 
--- I think we all need to be careful about assuming a mom's perceptions are wrong.  
Even if she does have an adequate supply, she is telling us something very important 
about her own concerns that should be dealt with in a serious and not a dismissive 
manner.

Best, Susan Burger

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