CAUSES OF POOR LACTATION

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Breast milk is the best form of nutrition for neonates and infants. It is important for brain, immune system and gut development. The hormone prolactin helps in milk production while oxytocin helps in milk ejection. Oxytocin is released when the baby starts to suckle.

Contrary to the popular perception of some mothers that their breastmilk production is inadequate, the truth is that most mothers can produce more breastmilk than their infants require. The more a mother allows her baby to suckle, the more breastmilk production occurs.  It is important to breastfeed at least 8-12 times during the first few days following delivery to increase milk production.

During breastfeeding, it is important to empty one breast fully, before moving the baby to the other breast. When that happens, the baby gets both fore and hind milk. The fore milk contains a lot of water and lactose. The hind milk contains a lot fat. Babies who get a lot of foremilk and hence lactose will grow well alright, but will get a lot of gaseous distention, irritability and explosive watery stools. This is called hyperlactation syndrome. To avoid this, the baby should get both the lactose and fat in the foremilk and hindmilk.

Since breastmilk supply is dependent on its removal and its ongoing synthesis, anything that interferes with this chain will interfere with its supply. For instance, stress and fatigue may reduce the number of times a mother puts the baby to breastfeed. This will reduce the rate at which breast milk is emptied and hence its production. There is a peptide hormone in breastmilk which inhibits breastmilk production if it accumulates in the breast. Emptying the breast reduces its accumulation and its effects of interfering with breastmilk production.

Other factors that affect breastmilk production include conditions that make it difficult for babies to suckle. Such conditions include extreme prematurity, neurological disabilities in the baby, cleft lip and palate, baby being ill and poor attachment to the breast.

In situations where a baby cannot suckle, the breast can be expressed or pumped to ensure it is emptied well so that the breastmilk production and emptying cycle will not be broken.

Dr Gloria Amponsah-Kodua

Paediatrician specialist

 

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