I produce very little breast milk

Real life experience
I have a three-and-a-half month-old baby and I returned to work a month ago. However, my breast milk supply has dwindled. This is my second child, but with my first-born, the supply reduced after nine months. 

My family on my mother’s side says they suffered from low breast milk supply. My grandmother says despite being in the village with lots of food, she also had a low supply. Now my relatives are saying it is genetic and I cannot do anything about it. I feel I can breastfeed my baby until it is one-and-a-half years old like I did with my first-born. 

I have tried various “milk-boosting” foods as advised by friends and relatives with little success. I have eaten katunkuma, leafy vegetables, offal, fruits, as well as drinking lots of maize and millet porridge and water. Instead I am just growing fat!

When I returned to work, my colleagues ensured that I was not overloaded and the baby’s caretakers are doing a good job of minding him, so I am not stressed by that.  

I am allowed to return home to breastfeed during my lunch break and my place of work is somewhat close by. However, when I get home at lunch time, the milk is usually so little that the baby gives up suckling and instead plays with the breast!

I am getting worried that the milk will dry up before the baby makes six months or worse, he will get comfortable with formula and we shall miss out on the bonding. I am also worried my baby will give up the breast completely! 

I am not on the pill as my husband works abroad and returns twice a year.

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Why this may happen

By Joyce Nyakato

Many a mother goes through a period of questioning whether their milk supply is adequate when they are breastfeeding their babies. However, according to Dr. Jessica Nsungwa, the assistant commissioner for child health, many women tend to think that their milk supply is low when it is not. 

If your baby is gaining weight well on breast milk alone, then you do not have a problem with milk supply. The feel of the breast, the behaviour of your baby, the frequency of nursing or the sensation of let-down are not valid ways to determine whether or not you have enough milk for your baby. 

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Why do some women complain of low supply breast milk?

A mother’s milk supply may diminish temporarily if she is not feeding her baby often. According to Dr. Robert Busingye, a senior consultant gynaecologist, some women produce more milk than others. However, every woman should try their best to produce adequate milk by breastfeeding more times. 

“The more you breastfeed, the more milk you produce,” Busingye says. 

Babies should also be introduced to breast milk in the first hour of birth. 

Even if there is no milk, the baby’s tongue can stimulate the breast thereby increasing production of milk. 

Giving babies formula, glucose and warm water interferes with the breast milk production cycle of the mother. Every bottle that your baby takes of these drinks means that your body gets the signal to produce less milk.

Dr. Nsungwa explains that when babies are constantly given formula or bottle milk, they will prefer it to breast milk. 

For a woman to produce enough milk, she needs to be in a good physical and psychological state of mind. She needs to have a balanced diet because a starving mother cannot produce enough milk. 

Most times, women may give birth under circumstances, which may stress them such as financial troubles, failed relationship and fatigue. Fatigued, stressed and restless mothers are less likely to produce enough milk for their babies. Dr. Nsungwa advises mothers to get enough rest to boost their milk supply. 

The anxiety created by the fear of failure to breastfeed and subsequent judgment from the community contributes to low milk supply. Since the hormones that are involved in milk production and let down are released from the brain, a poor state of mind effects on how well they operate. 

Dr. Nsungwa explains that although low supply of milk mainly comes from the mothers, sometimes it stems from the baby’s inability to get enough milk from the mother. The commonest cause of failure to breastfeed is the fact the baby has not latched on properly. The baby needs to be positioned so that they are facing the breast. Mothers should ensure that much of the darker part of the breast is in the baby’s mouth so that the nipple is towards the back of the mouth, and the child laps the breast not suck the nipple. Once this happens, the milk glands are stimulated and hormones, which cause to the brain to order for more production of milk become active. 

Many products claim to increase milk supply, but may be harmful to the mother and/or baby. The best way to ensure increase of breast milk is to breastfeed properly and frequently.

For the mother who is experiencing low milk supply, the loss of the opportunity to exclusively breastfeed is heartbreaking. Also achieving any kind of nursing relationship with the baby may seem near impossible. This can be difficult for the mother to handle emotionally. 

Rosemary Bwire, a counsellor at Uganda Christian University, says a new mother needs all the psycho-socio support of people around her. A good atmosphere around her will create an enabling environment for her to breastfeed her child. There is also a breastfeeding clinic at old Mulago that offers peer support to mothers and helps them share solutions for their breastfeeding challenges.

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When a new mother is all alone

By Agnes Kyotalengerire

Maria Gorretti did everything to prepare for the arrival of her first baby Ashley. However, she overlooked one aspect; that is, preparing a support network. 

A week after Maria was discharged from hospital and her mother-in-law had left, she was overwhelmed with chores and nursing the new-born baby. 

“I used to spend sleepless nights with the baby and yet during day I was overwhelmed with the house chores,” Maria narrates. 

In the second week, she could not take it anymore and headed to her parents’ home, where she spent her maternity leave.   

Joy Byenkya, the minister of gender and culture in Bunyoro Kitara Kingdom, says in the past, a new mother would not be allowed to do any housework. 

“She had support, for example, from her mother, mother-in-law or sister-in-law to help with chores. That way she dedicated her time to nursing her new-born baby,” she says. 

Byenkya, however, notes that today, many families, especially in urban areas, have small homes so they cannot host guests for long, leaving a new mother to work out things by herself.

Margaret Ssenyonjo, a senior midwife, says the first days after birth can be stressful for the new mother, which may affect the breast milk supply. This usually leads to some mothers giving up breastfeeding in the early weeks. 

“You are no good to your baby if you are starving, sleep-deprived and stressed,” she warns. 

Ssenyonjo recommends seeking help with the chores, especially in the first weeks. “You can employ a house-help or ask your family to help you,” she advises. 

You could also ask your spouse to help with the housework. “You are a team in parenting so work like one,” advises Rhoda Mukyala, a marriage counsellor.

Breastfeeding, especially getting the baby to latch onto the breast properly, does not come easily for many first-time mothers. After a few struggles with this issue, some mothers eventually abandon breastfeeding. 

Florence Nalubowa, a senior public nursing officer at the lactation unit Mulago Hospital, advises mothers to seek help when they face such challenges. She says the lactation unit receives about 10 mothers every week with breastfeeding challenges.