Many new mothers worry about their milk supply. For some, support from a breastfeeding counsellor or lactation consultant helps.

Others cannot make enough milk no matter how hard they try. These are women whose breasts are not physically capable of producing enough milk.

Our recently published research gives us clues about breast features that might make it difficult for some women to produce enough milk. Another of our studies shows the devastating consequences for women who dream of breastfeeding but find they cannot.

Some breasts just don’t develop

Unlike other organs, breasts are not fully developed at birth. There are key developmental stages as an embryo, then again during puberty and pregnancy.

At birth, the breast consists of a simple network of ducts. Usually during puberty, the glandular (milk-making) tissue part of the breast begins to develop and the ductal network expands. Then typically, further growth of the ductal network and glandular tissue during pregnancy prepares the breast for lactation.

But our online survey of women who report low milk supply gives us clues to anomalies in how some women’s breasts develop.

We’re not talking about women with small breasts, but women whose glandular tissue (shown in this diagram as “lobules”) is underdeveloped and have a condition called breast hypoplasia.

We don’t know how common this is. But it has been linked with lower rates of exclusive breastfeeding.

We also don’t know what causes it, with much of the research conducted in animals and not humans.

However, certain health conditions have been associated with it, including polycystic ovary syndrome and other endocrine (hormonal) conditions. A high body-mass index around the time of puberty may be another indicator.

Could I have breast hypoplasia?

Our survey and other research give clues about who may have breast hypoplasia.

But it’s important to note these characteristics are indicators and do not mean women exhibiting them will definitely be unable to exclusively breastfeed.

Indicators include:

• a wider than usual gap between the breasts
• tubular-shaped (rather than round) breasts
• asymmetric breasts (where the breasts are different sizes or shapes)
• lack of breast growth in pregnancy
• a delay in or absence of breast fullness in the days after giving birth

In our survey, 72% of women with low milk supply had breasts that did not change appearance during pregnancy, and about 70% reported at least one irregular-shaped breast.

The effects

Mothers with low milk supply – whether or not they have breast hyoplasia or some other condition that limits their ability to produce enough milk – report a range of emotions.

Research, including our own, shows this ranges from frustration, confusion and surprise to intense or profound feelings of failure, guilt, grief and despair.

Some mothers describe “breastfeeding grief” – a prolonged sense of loss or failure, due to being unable to connect with and nourish their baby through breastfeeding in the way they had hoped.

These feelings of failure, guilt, grief and despair can trigger symptoms of anxiety and depression for some women.

One woman told us:

[I became] so angry and upset with my body for not being able to produce enough milk.

Many women’s emotions intensified when they discovered that despite all their hard work, they were still unable to breastfeed their babies as planned. A few women described reaching their “breaking point”, and their experience felt “like death”, “the worst day of [my] life” or “hell”.

One participant told us:

I finally learned that ‘all women make enough milk’ was a lie. No amount of education or determination would make my breasts work. I felt deceived and let down by all my medical providers. How dare they have no answers for me when I desperately just wanted to feed my child naturally.

Others told us how they learned to accept their situation. Some women said they were relieved their infant was “finally satisfied” when they began supplementing with formula. One resolved to:

prioritise time with [my] baby over pumping for such little amounts.

Where to go for help

If you are struggling with low milk supply, it can help to see a lactation consultant for support and to determine the possible cause.

This will involve helping you try different strategies, such as optimising positioning and attachment during breastfeeding, or breastfeeding/expressing more frequently. You may need to consider taking a medication, such as domperidone, to see if your supply increases.

If these strategies do not help, there may be an underlying reason why you can’t make enough milk, such as insufficient glandular tissue (a confirmed inability to make a full supply due to breast hypoplasia).

Even if you have breast hypoplasia, you can still breastfeed by giving your baby extra milk (donor milk or formula) via a bottle or using a supplementer (which involves delivering milk at the breast via a tube linked to a bottle).

More resources

The following websites offer further information and support:

• Australian Breastfeeding Association
• Lactation Consultants of Australia and New Zealand
• Royal Women’s Hospital, Melbourne
• Supply Line Breastfeeders Support Group of Australia Facebook support group
• IGT And Low Milk Supply Support Group Facebook support group
• Breastfeeding Medicine Network Australia/New Zealand
• Supporting breastfeeding grief (a collection of resources).

Shannon Bennetts, a research fellow at La Trobe University, contributed to this article.

Renee Kam, PhD candidate and research officer, La Trobe University and Lisa Amir, Professor in Breastfeeding Research, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

We already know excessive smartphone use affects people’s mental health and their relationships.

But when new parents use digital technologies during care giving, they might also compromise their baby’s development.

Smartphone use in the presence of infants is associated with a range of negative developmental outcomes, including threats to the formation of a secure attachment.

The transition into parenthood is an ideal time for healthy behaviour change. Expectant parents see a range of professionals, but as we found in our new study, they don’t receive any co-ordinated support or advice on managing digital devices in babies’ presence.

One of the new mums we interviewed said:

Literally nothing has come up around […] screen time, or especially breastfeeding and things like that […] it’s interesting because it’s such a big part of our lives.

Another participant said:

I haven’t had anyone talk to me about tech use, at all.

Adult smartphone use is not mentioned in well-child checks. We argue this is a missed public health opportunity.

Secure attachment is important for a baby’s development. They need hours of gazing at their families’ faces to optimally wire their brains. This is more likely when the parent is sensitive to a baby’s cues and emotionally available.

But ubiquitous smartphone use by caregivers has the potential to disrupt attachment by interrupting this sensitivity and availability.

Babies’ central nervous system and senses are immature. But they are born into a rapidly moving world, filled with voices and faces from digital sources. This places a burden on caregivers to act as a human filter between a newborn’s neurobiology and digital distractions.

Disrupting relationships

Psychologists have described the phenomenon of frequent disruptions and distractions during parenting – and the disconnection of the in-person relationship – as “technoference”.

A caregiver’s eyes are no longer on the infant but on the device. Their attention is gone, in a state described as “absent presence”, and the phone becomes a “social pollution”.

It’s unpleasant for anyone on the other side of this imbalance. But for babies, whose connection to their significant adults is the only thing that can make them feel safe enough to learn and grow optimally, it causes disproportionate harm because of their vulnerable developmental stage.

During the rapid phase of brain growth in infancy, babies are wired to seek messages of safety from their caregiver’s face. Smartphone use blanks caregivers’ facial expressions in ways that cause physiological stress to babies.

When a caregiver uses their phone while feeding an infant, babies are more likely to be overfed. The number of audible notifications on a parent’s device relates to a child’s language development, with more alerts associated with fewer words at 18 months.

If that’s not reason enough to reign in phone use, evidence also shows that smartphone use can be a source of stress and guilt for parents. This suggests parents themselves would benefit from more purposeful and reduced smartphone habits.

Some public health researchers are urging healthcare workers to consider the parent-infant relationship in addition to the respective health of the baby and caregiver themselves.

This relational space between people is suffering as a result of the social pollution of smartphone-distracted care. Babies’ brains grow so fast, we mustn’t let this process be compromised by the distraction of the attention economy.

Our research shows new parents could use information and support around the use of digital devices. We also recommend that other family members modify their smartphone habits around a new baby. Whānau can create a family media plan and make sure they have someone to talk to about this issue.

Health policies should focus on early investment in parents and children, by prioritising education and action on smartphone use around babies. This would benefit the wellbeing of new parents and the lifelong development of infants.

Miriam McCaleb, Fellow in Public Health, University of Canterbury

This article is republished from The Conversation under a Creative Commons license. Read the original article.