Last week I was reading with interest the postings regarding the
mother who is having trouble getting her supply of milk started. Being a
student and a bit naive, I thought that as a long as a baby was put to
breast enough, the mother's milk would come in. This is a concerning
issue for mothers and lactation consultants. I have done a bit of
research to find causes of this problem. I found there are commonly known
reasons, and perhaps, some less understood causes of inadequate milk
supply, including obesity and ovarian cysts. I hope some of you find this
an interesting issue and can add some of your own experiences in regard to
this problem.
Marasco, Marmet & Shell (2000) state, between 2-15% of new mothers
are unable to produce enough milk to maintain their baby's health. They
go on to explain professionally accepted causes for this condition such as
uncontrolled diabetes, low thyroid hormone, pituitary problems,
hemorrhaging and breast surgeries. Hoover, Barbalinardo & Platia (2002)
also give retained placental fragments, mag. sulfate ues, obesity,
Sheehan's syndrome, radiation therapy, cigarette smoking, and some meds as
reason for delayed milk supply.
Marasco et al.(2000) looked at women with poly-cystic ovarian
syndrome and their high rates of BF failure. These authors concluded that
these women need to be followed closely, but the reason for BF failure in
these women was not completely understood.
In 2002, Hoover et al. published a case report stating information on
gestational ovarian theca lutein cysts. These cysts appear during
pregnancy and substantially raise the mother's testosterone level. The
authors relate the hypothesis of the endocrinologist is the high level of
testosterone had delayed lactogenesis II (the onset of a substantial milk
supply).
Hill, Aldag, Chatterton and Zinaman (2005) published a study in the
Western Journal of Nursing Research that looked at the correlation of
psychological stress, fatigue and low milk supply in term and pre-term
mothers. The researchers found no correlation between the mother's
percieved stress and milk volume. Stress has received its share of blame
in low milk supply, so it is good to know that may just be an old wives
tale.
A study by Rasmussen and Kjolhede (2004) indicates a link in the
amount of prolactin produced by overweight and obese mothers. Prolactin
levels are significantly below normal 2 & 7 days post-partum, and could
also inhibit lactogenesis II.
References:
REFERENCES:
Hill, P. Aldag, J. Chatterton, R. and Zinaman, M. (2005) Psychological
distress and milk
volume in lactating mothers. Western journal of nursing research. 27
(6): 676-693.
Hoover, Barbalinardo & Platia (2002) Delayed lactogenesis II secondary to
gestational ovarian
theca lutein cysts in two normal singleton pregnancies. Journal of
human lactation 18(3):
264-268
Marasco, L. Marmet, C. & Shell, E. (2000) Polycystic ovarian syndrome: A
connection to
insufficient mild supply? Journal of human lactation. 16(2):143-148.
Rasmussen, K. & and Kjolhede, C. (May, 2004) Prepregnant overweight and
obesity diminish
the prolactin response to suckling in the first week postpartum.
Pediatrics 113(5): 465-470.
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