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    A Mother's Dilemma

    Not enough milk?

    WebMD Feature
    Reviewed by Craig H. Kliger, MD

    July 31, 2000 -- Breastfeeding my first son Julian hadn't gone as I had planned. For months I prepared, just like all the moms I knew. I attended a breastfeeding workshop, selected a pro-breastfeeding pediatrician, hired an ardent breastfeeding advocate to be our birth and labor coach, and read up on the subject in many pregnancy and parenting books.

    All to no avail. After Julian was born, I immediately knew something was wrong: My breasts didn't engorge or leak milk. I couldn't hear Julian swallow. And he never seemed satisfied after feedings. The problem, I discovered, was that my milk simply failed to come in. That discovery launched a confusing and emotional struggle to provide my son with the benefits of nursing while making sure he got enough to eat.

    Between Two Camps

    At first, everyone pooh-poohed my concerns. But within days they agreed there was a problem. Julian was rapidly losing weight, and he wasn't peeing or pooping. The hospital strongly recommended supplementing with formula, and I reluctantly allowed them to do so in 1- and 2-ounce increments, remembering all the dire warnings I'd read about the evils of supplementation. It was a slippery slope that would lead to more bottles and less nursing, then to less supply and, ultimately, to what the pro-breastfeeding experts called the worst of all possible fates -- "premature weaning."

    Family members, friends, and professionals around me fell into two camps, neither terribly supportive. One urged me to give up on breastfeeding altogether and could not understand my dismay over what was happening. The other was convinced that I was doing something wrong and heaped upon me huge amounts of guilt.

    My doula, a birth and post-partum coach I hired, ruefully told my husband and me that we'd "gone a bit overboard" after we confessed to giving the baby 5 ounces of formula the previous night despite fervent efforts to nurse. She also suggested that my milk supply had been derailed by how "career-minded" I'd been before having the baby. Much later, I discovered that the community of lactation professionals was just beginning to grudgingly admit that there really are bonafide cases of low milk supply.

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