The Syndrome of Insufficient Milk Supply and the Wisdom of Yoda   by Lakeshore Medical Breastfeeding Medicine Clinic


An approach to low milk supply is here because I'm not suggesting this is the only cause.


Intentional title.  I think it's really called "perceived insufficient milk supply" but I'm an allopathic doctor and as I understand that description, I need a disease to talk about.  I'm also a big geek, and as I understand that definition, I should be able to quote Star Wars.  Hands down, my favorite quote is from Yoda in the "Empire Strikes Back" when Luke is in a swamp, training to be a Jedi. Luke is having a hard time with this Jedi stuff and starts to complain.  Yoda says ""Do, or do not. There is no try."  


We aren't in a swamp trying to master a skill we aren't sure we are ready for (are we?) but we are certainly trying and hoping that we are adequate. The subtext of too many conversations about breastfeeding is a feeling of inadequacy and many of our perceptions are just upside down: we think that a baby spending lots of time at the breast must not be getting enough when they just love being with you and are getting plenty; or a baby who quiets when picked up is "spoiled" (so you already messed them up) instead of responding to your attention and concern (which does not cause messed up babies). It's always there: am I good enough?  Do I have enough milk?


I went on and on about possible physiologic explanations for low milk supply here, so this isn't written about those mothers who have explanations for low supply, or can't find an explanation for their low supply.  It is for those mothers that misperceive their actual supply.  This idea that mothers are supplementing and weaning because they feel as if they have "no milk" or "I can't satisfy him" is as important as Star Wars.  It's a cultural phenomenon. It's everywhere.  It's marketed, and grosses lots of money. And the story is passed down from generation to generation.  And if you have no Yoda to inspire you, well, there may be a dark side.  At about 3:00 am.  When you don't understand what the baby is doing.  And you are starting to believe all those subversive messages that are so pervasive.


The most common reason for the perception that a mother's body can't make enough milk for her baby is lack of confidence expressed as "I can't satisfy him."   Crying is a big deal too.  Mothers always seem to blame the crying on themselves first (supply, diet, gas) without looking for other reasons the baby might cry.  Like an older sibling who just knocked them over.


So what else may lead to the "dark side" thoughts?  Well, lack of social support for one. We have lost our tribes, the people who breastfed before we did who can help us troubleshoot or explain what the baby might be doing. Perhaps it's marketing practices of infant formula companies. (I'm going to skip the "perhaps.") Maybe it's hospital practices like separation of the mother and infant, or poor, evidenceless- based maternity care practices. Or maybe providers get in the way with the "3Bs" of bilirubin, birth weight and blood sugar causing early supplementation. Maybe it's under-education of what a normal newborn is supposed to do. Of course, maybe "I don't have enough milk" is a socially acceptable way to stop breastfeeding.


What perceived insuffient milk supply is, at its root, is lack of confidence, for whatever reason.  That the body that created the beautiful baby can't possibly satisfy him, even though you are trying.


Go ahead and try, and then step back and see your baby, their growth, their smile, their desire to be with you, and realize that despite the cacophony of epic Star Wars- like messages of "you can not," you do.


Celebrate your inner Jedi.


Jenny Thomas, MD, MPH, IBCLC, FABM, FAAP




More info on causes of low milk supply:

More in on the normal newborn (quoted above):

The Three "Bs":