The Milky Way: A Guest Post by Kathleen McCue

Today’s post is a guest post from Kathleen McCue, a lactation consultant and wonderful writer. Kathleen was nice enough to send me a copy of her book Mother to Mother, a truly charming and heartfelt book full of advice from other moms. For this post, she’s writing about low milk supply, a subject that is dear to my heart. I struggled to keep my supply where it needed and have heard many experiences from moms who believe to have had low milk supply, even though it is incredibly rare to have a supply low enough that you truly cannot nurse. Kathleen offers some very interesting theories on how our society and routines can hurt milk supply. 

As a lactation consultant, I spend a substantial amount of time counseling mothers on milk supply. “I have too much milk” or, “My supply is so low, I have to supplement with formula at every feeding.”

For some reason, how successful a mom is with breastfeeding is directly related to her idea of how successful a mother she is. So, you can see where low milk supply issues can drastically impact a mom down to her core. So, what happens to cause low supply? Where does this phenomenon originate. My thought is that it often happens during the first hour after birth when, instead of coming right to breast, babies are whisked away for weights, measurements, footprints, vital signs, apgar scores, suctioning and placement of what I call “the LoJack” around the ankle. I do realize the suctioning and possibly the apgar scores are critical functions after birth but believe these can be done while baby is skin-to-skin on mom.

There’s a beautiful video of a baby girl being delivered vaginally and immediately being placed right on top of her mom’s lower abdomen. During the 45-minute video, the baby CRAWLS from that position all the way up to her mom’s breast and drops her head right over the nipple! Of course I saw this movie with a group of other lactation consultants and there wasn’t a dry eye in the house. So miraculous when you think of it and so different from what usually happens.

I constantly hear stories of babies being taken from their moms during that first hour to satisfy hospital protocol. When baby is usually returned to the mom, washed well and wrapped tightly in a blanket, they’re too tired to do anything. There’s ONLY that ONE golden hour to take advantage of before the baby naturally does some pretty deep sleeping for the next 23 hours. Although skin-to-skin is still important after that hour, it doesn’t have the exact same impact.

Another supply killer is the practice of some hospital personnel and nursing staff offering to take babies away to the nursery so moms can get some sleep. Afterwards, they return with results of a hospital protocol heel stick showing the baby now has a low blood glucose level. Really? Moms are advised to immediately give formula (not sure why we can’t give colostrum), and it’s there that the slope becomes even more slippery.

One mom I worked with last week told me a story of a post partum nurse telling her that her baby was “crying because he wants a hamburger and all you have is a French fry.” A real confidence boost, don’t you think?

Another mom told me that when she arrived home from the hospital, her mother was there heating up formula because “Breastfeeding doesn’t work well for Smith women” (not the real name).

What do people think formula is? Just the name alone makes it sound important, doesn’t it? Lactation consultants frequently call it “Artificial breastmilk.” For one, it’s not even species specific since it’s made from cow’s milk. Having said that, I highly recommend it to women with inadequate supply; at least until we get the maternal supply up. Babies can’t wait and aren’t very subtle about letting moms know where they stand.

Bags of formula and other treats for moms do nothing more than undermine womens’ sense of self. It’s akin to handing out six-packs at AA meetings….Here’s the 12 steps for recovery madam, but if it doesn’t work out, here’s a six pack of Bud Light.

We need to support women, right from the start with their “Breast Intentions.” Baby to the breast within the first hour, rooming in, frequent skin-to-skin, lactation consultants in Baby Friendly hospitals and more community resources for follow-up.

I often tell moms struggling “I believe in you. Your breasts are 3 million years of evolution sitting right there on your chest.” Melodramatic? Perhaps, but that’s what women need for this confidence game called breastfeeding.

About Kathleen McCue:

Each mother and baby is an individual with unique needs and circumstances. With the knowledge of many years (38 yikes!) as a nurse practitioner and assisting well over 5,000 mothers achieve a positive and nurturing breastfeeding experience, Kathy is also able to respond to a broad range of medical circumstances, that arise in the course of breastfeeding a baby.

“I feel it is paramount to understand what the mother’s objectives are for the nursing experience. By listening to the mother, I can help her create an environment of peace and understanding where both the mother and baby can thrive and grow.”

After understanding the mother’s objectives and lifestyle needs, her philosophy is to then approach the teaching of breastfeeding from the perspective of the baby. After explaining the needs and reflexes of infants, she then matches the breastfeeding goals of the mother to help the mother-baby couple create a unique, synergistic nursing relationship.


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