I am going to go out on a limb here and share some of my thoughts and
observations.

I have been a LLL Leader for more than 21 years, and this gives me a
different perspective than those of you who are working in hospitals or
clinics. I often see the mother for many months, can often spend time at her
home (or have her over to mine), so I have the chance to make more
observations.

I have seen only a very few of these situations where mothers found their
milk supply dropped drastically at around three or four months, and in every
single case I was seeing what looks to me like fairly infrequent feeding
and/or baby sleeping at night.

The majority of mothers I know and work with breastfeed their babies quite
frequently - for comfort, to help baby get to sleep, to get baby back to
sleep, for thirst, for hunger, just because he wants to suck, etc. I've
never actually counted how many times a day these babies are at the breast,
but it is frequent, although each feeding may be brief, and the gaps between
feedings are not long.

I have never seen this sudden drop in milk supply in mothers who breastfeed
this way.

In each case where I have seen it, the mother was feeding perhaps every
three or four hours or so and keeping pretty much to that kind of pattern.
If the baby was tired, she might rock him to sleep or give him a pacifier.
If the baby fussed, she might carry him around, give a pacifier, or rub his
back, or put him in a wind-up swing. These babies tended to have longer
feedings at longer intervals. Some have learned to sleep through the night
at a pretty early age. Their weight gain is good, and so is the mother's
milk supply.

All the cases I have seen of the 4-month drop in supply seem to happen in
this second group. It certainly doesn't happen with all of them - many,
perhaps most, can do just find breastfeeding this way. But for some it seems
as though the frequency of stimulation to the breast with this pattern is
just not frequent enough to keep the process of milk production going.

I would also link this to that 4-hour or 5-hour feeding rule that was being
discussed in another thread. Perhaps it was suggested that some babies
should be fed at this point not because the baby would otherwise be at risk,
but because someone had observed that for some women, infrequent feedings
lead to reduced milk supply?

Teresa Pitman
Guelph, Ontario

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