What Causes Low Milk Supply in Breastfeeding (Part 3)

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This is part 3 of ‘What Causes Low Milk Supply in Breastfeeding’ series. If you haven’t read the previous parts, you can read part 1 and part 2 here.

As I promised previously, this article will guide you to identify cause of low milk supply from your baby side.

Things causing low milk supply from your baby’s side

#1 Suck problem

Effective sucking relies on baby’s ability to coordinate the use of his tongue, cheeks, palate, jaw, facial muscles, and lips. Any significant variations on these structure may affect your baby’s sucking ability.

You will know your baby may have sucking problem if you experience the following:

• constant nipple pain during feeding or nipple came out oddly shaped after each feeding
• your breast still feels full after feeding

And this keeps occurring no matter how you attempt to latch your baby deeply.

Some babies may have sucking problem in the early days after birth due to pain medications that you receive during labor, but this problem is usually temporary and will disappear on its own once the medication gets eliminated from baby’s body.
Some babies started with good sucking, but started to develop sporadic sucking on his desperate attempt to get as much as milk from the breast.

To fix this, you need to build up a good supply by pumping in addition to direct feeding and always encourage baby to latch deeply by taking not only nipple but also part of areola. At the same time, your baby may need to undergo suck training exercises or specific therapies (such as craniosacral therapies). Please consult on medical practitioner to get necessary support and treatment.

#2 Tongue-tie

A baby’s ability to extract milk from the breast depends on his ability to move his tongue freely. A tongue-tie baby has lack of tongue flexibility to nurse effectively because the membrane that connects the base of the tongue to the floor of the mouth (called frenulum) , is too tight. You can see here for variations of tongue tie cases in babies. 

To check whether your baby is tongue-tie, you can do Murphy maneuver, by inserting your little finger below baby’s tongue and try to sweep from left to right. If you significant bump along the way (as in you cannot sweep freely unless by pulling out your finger a little bit), your baby may have a tongue tie.

If you suspect this is the case, you should consult further with your pediatrician or lactation consultant. They may suggest to do a frenotomy (a small treatment to divide the membrane with surgical laser or scissor) to release the tongue so that your baby can breastfeed more effectively. Until the treatment can be done, it is necessary for you to express milk to maintain your milk supply.

The website tonguetie.net will provide you with more information on how to detect tongue tie, its effects on baby’s feeding ability and speech development as well as the possible treatments.

#3 Palatal variation

Palate is the roof of mouth which separate the oral cavity and nasal cavity. A normal palate is necessary for your baby to breastfeed effectively so that he can draw in breast deeply and maintain the suction to extract milk out of breast.

With palatal variation, your baby may be reluctant to latch deeply and switch to a shallower latch position instead. Some palatal variation includes high palate (where baby’s palate is abnormally higher than usual) and cleft lip and palate.

Typically, a medical treatment is needed to correct your baby’s palate, but the recommended age for treatment varies from early months to some time around one year old.

While nursing in a natural, laid-back position,  may help these babies to draw more milk from breast, pumping is highly recommended to establish and maintain your milk supply until your baby can nurse more comfortably. But, can breastfeeding be done? The answer is yes. Here’s one encouraging story from a mama with cleft-palate baby. An another website dedicated for resources of cleft lip palate and breastfeeding.

#4 Muscle dysfunction (hypotonia / hypertonia)

Baby with low muscle tone (hypotonia) usually occurs with Down syndrome or other neurological issue.

They have difficulty in maintaining a deep latch and strong suction necessary to remove milk from breast. Their suck may feel weak or light.

They tire out easily during feeding because their muscle dysfunction.

On the contrary, hypertonic babies tend to feel tense during feeding, indicated by frequent latch and unlatch from the breast. Sometimes they even clench jaws during feeding, which can be painful for the mother, creating unpleasant breastfeeding experience.

For these types of babies, it is critical to help them relax prior to feeding. It can be by swaddling or walking and rocking them, and having as much skin to skin contact as possible.

Certain breastfeeding position may help these babies to breastfeed more effectively. Please consult with doctor and lactation consultant regarding possible solution and treatment. For further reading, this guide of making more milk provide very clear explanation for each of these anatomical variations and step by step guide on what you can do to encourage baby to nurse more effectively.

When direct nursing seems to be tough, you can always resort to pump and feed method to let your baby get the benefit of breast milk. Please remember that you are not alone. There are other mamas out there with similar problem. Click here to read story of a mother who was exclusively pumping breast milk for her hypotonic baby.

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There are  less common disease or anatomical variation that may affect the effectiveness of baby’s sucking and may affect your milk supply. If you suspect your low milk supply may be due to something uncommon in your baby, please consult your lactation consultant and pediatrician to find out the cause and get the correct treatment. For further reading, I strongly recommend you to read the breastfeeding mother’s guide to making more milk. It has one full chapter discussing solely about this (Oh, and it has Kindle edition, making it easier for you to read any where).

 

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So, how is it so far? I hope you start identifying the cause of your milk supply issue and get the right treatment. If not, you may want to continue reading the last chapter of this series.

In the next and last chapter of ‘What Causes Low Milk Supply in Breastfeeding’ series, I’ll talk about things on mom’s body that may affect milk supply.

If you want to read the previous 2 parts of this series, head over to the landing page here.