Sarah's comments reminded me of a mom that I visited with a Public Health Nurse as a PHN/IBCLC.  She was home schooling 5 children she had breastfed, but #6 was not gaining.  All the children and the mom wore dark blue slacks or skirts and white tops.  Not a peep was heard from the children when we made our first visit (we asked if we could see them, but father said they were busy with schoolwork.).  On a second visit, baby still not gaining much, and we spent some time talking to dad - who was very interested in sharing his own interpretation of the bible and ways to raise children.  He mentioned his strict rules about getting up, dressing, eating, etc.  which raised some red flags.  When we talked privately with mom, she reported he served the meals, but she often gave some of her portion to the other children, as she was sure her baby would get enough from her milk, and they were hungy.  We spoke to dad about the importance for him, as head of the household, to make sure she received enough food for herself and the food needed for mom to make more milk, as well as allowing the children appropriate portions. He reported he was doing the best he could, and the Public Health Nurse provided support and access to food distribution centers as well as other resources.  A large increase occurred the next visit....

A second issue occurred in a La Leche League Meeting - baby not gaining - in fact about the same as birth at 4 weeks.  Mom explained that it was important to her to get back to pre-pregnancy weight by the time baby was 6 weeks old.  In a private conversation with one of the Leaders, she admitted she was bulimic.   She was encouraged to get help for this, and my co-Leader was a dietitian, so she discussed some options.  However, she was also encouraged to speak to the pediatrician about supplementation.  She did stop breastfeeding.  There are times when that is the only option a mother will consider.

There are so many complications we come across that are not an "easy fix" - especially those related to mental health ...and body image!  It goes so much further back than the pregnancy, birth and breastfeeding.  

Jeanette Panchula, BA-SW, RN, PHN, IBCLC
...and La Leche League Leader since 1975...


Date:    Sat, 23 May 2020 12:12:47 +0100
From:    Sarah McCann <[log in to unmask]>
Subject: 'low quality' milk

Dear lactnet,
This is a very interesting discussion with lots of info and reminders in there.
Just to add from my own experience of working with mums - I worked with 2 mums with weight gain issues where the mums probably had eating disorders.
The first came to a LLL meeting worried about weight gain - she was so thin in the arm I asked her was she ill. She was wearing strange clothes, in that her clothes looked home made, uniformly pale blue (obviously not usually an issue) and super baggy . Sadly she gave up breastfeeding. I was trying not to be judgemental about her look but I suspected later that she was anorexic. The second mum came often to the group. Weirdly I knew from her mother-in-law that she had food issues - again very skinny, but perfectly turned out (hair matched her clothes). I think she breastfed for a while but gave up with weight gain issues after about 8 weeks.With her second baby I had more contact and she got in touch as the baby became fussy. We discussed food and when she increased her calorie intake the baby was less fussy. I think she knew her calorie intake was usually 1500 calories /day - huge red flag for lots of reasons. I think she breastfed to nearly a year. I remember chatting to a midwife friend about the 2 cases, as we are told that mums in a famine can breastfeed. She pointed out that anorexia is a huge issue for the body over years and so presumably the body has no fat stores. I also suspect the famine issue is complicated.
Detective work is what makes breastfeeding problems so interesting.
Nearly forgot I also had 3 mums with baby struggling with weight gain where dad was smaller than mum - shorter and finer. All kept breastfeeding and the weight issues resolved over time. One of the mums it was her second baby ~(out of 4) who struggled - health visitor weighed the baby weekly and came to the conclusion that baby had a high metabolism, she is now a finely built skinny teen. (I am not convinced about the metabolism but mum is also tall and thin, while dad is short and neat, so who knows).
Hope that is some help.
Best wishes,
Sarah McCann
BScHons, PgDip, IBCLC, LLL Leader
Carrickfergus, Northern Ireland.

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