CHICAGO — After struggling to breast-feed her first two children, Nyssa Retter was determined to do better with her third.
She gave birth without painkillers, which may make newborns slightly drowsy. She chose a free-standing birth center staffed with lactation-savvy midwives. She had skin-to-skin contact with her daughter immediately after birth and consulted with midwives when her daughter cried and screamed between near-constant feedings.
But at the baby’s two-week weigh-in, Retter learned that, despite all her efforts, her daughter was still below her birth weight and would need formula supplementation.
It was only then that Retter verbally cornered a lactation consultant and finally received a diagnosis.
“I have IGT, don’t I?” said Retter, who had read online about insufficient glandular tissue, a breast condition strongly associated with the inability to produce enough milk for a baby.
“Yes,” said the lactation consultant. “I think you do.”
In an era when “breast is best” is trumpeted by the government, by the medical profession and even by baby formula companies, an estimated 1 to 5 percent of women are physically unable to produce enough milk to feed their babies.
These women are often ignored by doctors, given the brushoff by old-school lactation consultants, and essentially left to fend for themselves.
It’s a measure of how little attention chronic, primary or “true” low milk supply has received, that no one knows for sure how many women are affected.
The most commonly recognized causes of chronic low milk supply are IGT — in which it is believed that the milk-producing structures in the breast have failed to develop properly — and breast surgery, in which the ducts, or tubes, that carry milk to the nipple may be severed.
Research on IGT and its effect on lactation is almost nonexistent, with the most widely quoted study cobbled together in 2000 by enterprising nurses and lactation consultants who assembled 33 breast-feeding women with breast characteristics that they suspected were linked to low milk production. The results were striking. Women with characteristics such as a wide space between the breasts, breasts with a pronounced lack of fullness, breasts with unusually small base circumferences, and breasts that didn’t grow during pregnancy, experienced very high rates of chronic low milk supply.
In the first month, 55 percent of the women in the study produced half or less than half of the milk their babies needed.
Some women with low milk supply switch to formula feeding, saying that grueling pumping routines produce minimal milk and major stress.
“Dealing with low milk supply, it’s whatever keeps you sane — that’s the most important thing to do,” says Retter, 28, who has been breast-feeding her daughter for two years, supplementing with formula and documenting her experience at her blog, Diary of a Lactation Failure. “If (breast-feeding) works for you, it’s worth it to pull through the really hard days, because once you get an older nursing baby, it’s a lot of fun.” — MCT