Some women’s breasts can’t make enough milk, and the effects can be devastating

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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.

Anatomical diagram of the breast
Sometimes not enough glandular tissue, shown here as lobules, develop.
Tsuyna/Shutterstock

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.

Tired, stress woman with hand over face
Feelings of failure, guilt, grief and despair were common.
Bricolage/Shutterstock

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:

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

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.

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  • The Best Exercise to Stop Your Legs From Giving Out

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Doug Weiss, seniors-specialist physio, has an exercise that stops your knees from being tricked into collapsing (which is very common) by a misfiring (also common) reflex.

    Step up…

     Setup to step up thus:

    •         Use a sturdy support like a countertop or chair.
    •         Have an aerobic step or similar firm surface to step onto.

       When you’re ready:

    •         Stand facing away from the step.
    •         Place one hand on the support for stability.
    •         Step backwards up onto the step with your right leg, then your left leg, so both feet are on the step.
    •         Step forward to come back down.

    Once you’re confident of the series of movements, do it without the support, and do it for a few minutes each day. Don’t worry about how easy it becomes; this is not, first and foremost, a strength-training exercise; you don’t have to start adding weights or anything (although of course you can if you want).

    How it works: there’s a part of you called the Golgi tendon organ, and it can trigger a Golgi tendon reflex, which is one of the body’s equivalents of a steam valve. However, instead of letting off steam to avoid a boiler explosion, it collapses a joint to save it from overload. However, if not exercised regularly, it can get overly sensitive, causing it to mistake your mere bodyweight for an overload. So, it collapses, thinking it is saving you from snapping a tendon, but it’s not. By exercising in the way described, the Golgi tendon reflex will go back to only being triggered by an actual overload, not the mere act of stepping.

    Writer’s note: this one’s interesting to me as I have a) a strong lower body b) hypermobile joints that thus occasionally just fold like laundry regardless. Could it be that this will fix that? I guess I’ll find out 🙂

    Meanwhile, for more on all of the above plus a visual demonstration, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like:

    What Nobody Teaches You About Strengthening Your Knees

    Take care!

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  • Ashwagandha: The Root of All Even-Mindedness?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Ashwagandha: The Root Of All Even-Mindedness?

    In the past few years, Ashwagandha root has been enjoying popular use in consumer products ranging from specialist nootropic supplement stacks, to supermarket teas and hot chocolates.

    This herb is considered to have a calming effect, but the science goes a lot deeper than that. Let’s take a look!

    Last summer, a systematic review was conducted, that asked the question:

    Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress?

    While they broadly found the answer was “yes”, they expressed low confidence, and even went so far as to say there was contradictory evidence. We (10almonds) were not able to find any contradictory evidence, and their own full article had been made inaccessible to the public, so we couldn’t double-check theirs.

    We promptly did our own research review, and we found many studies this year supporting Ashwaghanda’s use for the management of anxiety and stress, amongst other benefits.

    First, know: Ashwagandha’s scientific name is “Withania somnifera”, so if you see that (or a derivative of it) mentioned in a paper or extract, it’s the same thing.

    Onto the benefits…

    A study from the same summer investigated “the efficacy of Withania somnifera supplementation on adults’ cognition and mood”, and declared that:

    “in conclusion, Ashwagandha supplementation may improve the physiological, cognitive, and psychological effects of stress.”

    We notice the legalistic “may improve”, but the data itself seems more compelling than that, because the study showed that it in fact “did improve” those things. Specifically, Ashwagandha out-performed placebo in most things they measured, and most (statistically) significantly, reduced cortisol output measurably. Cortisol, for any unfamiliar, is “the stress hormone”.

    Another study that looked into its anti-stress properties is this one:

    Ashwagandha Modulates Stress, Sleep Dynamics, and Mental Clarity

    This study showed that Ashwagandha significantly outperformed placebo in many ways, including:

    • sleep quality
    • cognitive function
    • energy, and
    • perceptions of stress management.

    Ashwagandha is popular among students, because it alleviates stress while also promising benefits to memory, attention, and thinking. So, this study on students caught our eye:

    The Perceived Impact of Ashwagandha on Stress, Sleep Quality, Energy, and Mental Clarity for College Students: Qualitative Analysis of a Double-Blind Randomized Control Trial

    Their findings demonstrated that Ashwagandha increased college students’ perceived well-being through supporting sustained energy, heightened mental clarity, and enhanced sleep quality.

    That was about perceived well-being and based on self-reports, though

    So: what about hard science?

    A later study (in September) found supplementation with 400 mg of Ashwagandha improved executive function, helped sustain attention, and increased short-term/working memory.

    Read the study: Effects of Acute Ashwagandha Ingestion on Cognitive Function

    ❝But aside from the benefits regarding stress, anxiety, sleep quality, cognitive function, energy levels, attention, executive function, and memory, what has Ashwagandha ever done for us?

    Well, there have been studies investigating its worth against depression, like this one:

    Can Traditional Treatment Such as Ashwagandha Be Beneficial in Treating Depression?

    Their broad answer: Ashwagandha works against depression, but they don’t know how it works.

    They did add: “Studies also show that ashwagandha may bolster the immune system, increase stamina, fight inflammation and infection, combat tumors*, reduce stress, revive the libido, protect the liver and soothe jangled nerves.

    That’s quite a lot, including a lot of physical benefits we’ve not explored in this research review which was more about Ashwagandha’s use as a nootropic!

    We’ve been focusing on the more mainstream, well-studied benefits, but for any interested in Ashwagandha’s anti-cancer potential, here’s an example:

    Evaluating anticancer properties of [Ashwagandha Extract]-a potent phytochemical

    In summary:

    There is a huge weight of evidence (of which we’ve barely skimmed the surface here in this newsletter, but there’s only so much we can include, so we try to whittle it down to the highest quality most recent most relevant research) to indicate that Ashwagandha is effective…

    • Against stress
    • Against anxiety
    • Against depression
    • For sleep quality
    • For memory (working, short-term, and long-term)
    • For mental clarity
    • For attention
    • For stamina
    • For energy levels
    • For libido
    • For immune response
    • Against inflammation
    • Against cancer
    • And more*

    *(seriously, this is not hyperbole… We didn’t even look at its liver-protective functions, for instance)

    Bottom line:

    You’d probably like some Ashwagandha now, right? We know we would.

    We don’t sell it (or anything else, for that matter), but happily the Internet does:

    Try Out Ashwagandha For Yourself Here!

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  • Change Your Brain, Change Your Life – by Dr. Daniel G. Amen

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    To what extent can we change our brains, and to what extent are we stuck with what we have?

    Dr. Amen tells us that being mindful of both ends of this is critical:

    • Neuroplasticity means we can, indeed, change our brains
    • We do, however, have fundamental “brain types” based on our neurochemistry and physical brain structure

    He argues for the use of brain imaging technology to learn more about the latter… In order to better go about doing what we can with the former.

    The book looks at how these different brain types can lead to situations where what works as a treatment for one person can often not work for another. It’s also prescriptive, about what sorts of treatments (and lifestyle adjustments) are more likely to do better for each.

    Where the book excels is in giving ideas and pointers for exploration… Things to take to one’s doctor, and—for example—request certain tests, and then what to do with those.

    Where the book is a little light is on including hard science in the explanations. The hard science is referred to, but is considered beyond the scope of the book, or perhaps beyond the interest of the reader. That’s unfortunate, as we’d have liked to have seen more of it, rather than taking claims at face value without evidence.

    Bottom line: this is distinctly “pop science” in presentation, but can give a lot of great ideas for learning more about our own brains and brain health… And then optimizing such.

    Click here to check out “Change Your Brain; Change Your Life” on Amazon today!

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    Why Jasmine’s Video is Useful

    Jasmine McDonald is not only a professional ballerina, but is also a certified personal trainer, so when it comes to keeping her body strong and flexible, she’s a wealth of knowledge. Her video (below) is a great example of this.

    In case you’re interested in learning more, she currently (privately) tutors over 30 people on a day-to-day basis. You can contact her here!

    Other Stretches?

    If you think that Jasmine’s stretches may be out of your league, we recommend checking out our other articles on stretching, including:

    Otherwise, let loose on these dancer stretches and exercises:

    How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

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  • What does it mean to be transgender?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Transgender media coverage has surged in recent years for a wide range of reasons. While there are more transgender television characters than ever before, hundreds of bills are targeting transgender people’s access to medical care, sports teams, gender-specific public spaces, and other institutions.

    Despite the increase in conversation about the transgender community, public confusion around transgender identity remains.

    Read on to learn more about what it means to be transgender and understand challenges transgender people may face.

    What does it mean to be transgender?

    Transgender—or “trans”—is an umbrella term for people whose gender identity or gender expression does not conform to their sex assigned at birth. People can discover they are trans at any age.

    Gender identity refers to a person’s inner sense of being a woman, a man, neither, both, or something else entirely. Trans people who don’t feel like women or men might describe themselves as nonbinary, agender, genderqueer, or two-spirit, among other terms.

    Gender expression describes the way a person communicates their gender through their appearance—such as their clothing or hairstyle—and behavior.

    A person whose gender expression doesn’t conform to the expectations of their assigned sex may not identify as trans. The only way to know for sure if someone is trans is if they tell you.

    Cisgender—or “cis”—describes people whose gender identities match the sex they were assigned at birth.

    How long have transgender people existed?

    Being trans isn’t new. Although the word “transgender” only dates back to the 1960s, people whose identities defy traditional gender expectations have existed across cultures throughout recorded history.

    How many people are transgender?

    A 2022 Williams Institute study estimates that 1.6 million people over the age of 13 identify as transgender in the United States.

    Is being transgender a mental health condition?

    No. Conveying and communicating about your gender in a way that feels authentic to you is a normal and necessary part of self-expression.

    Social and legal stigma, bullying, discrimination, harassment, negative media messages, and barriers to gender-affirming medical care can cause psychological distress for trans people. This is especially true for trans people of color, who face significantly higher rates of violence, poverty, housing instability, and incarceration—but trans identity itself is not a mental health condition.

    What is gender dysphoria?

    Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity, or their internal sense of gender. A 2021 study of trans adults pursuing gender-affirming medical care found that most participants started experiencing gender dysphoria by the time they were 7.

    When trans people don’t receive the support they need to manage gender dysphoria, they may experience depression, anxiety, social isolation, suicidal ideation, substance use disorder, eating disorders, and self-injury.

    How do trans people manage gender dysphoria?

    Every trans person’s experience with gender dysphoria is unique. Some trans people may alleviate dysphoria by wearing gender-affirming clothing or by asking others to refer to them by a new name and use pronouns that accurately reflect their gender identity. The 2022 U.S. Trans Survey found that nearly all trans participants who lived as a different gender than the sex they were assigned at birth reported that they were more satisfied with their lives.

    Some trans people may also manage dysphoria by pursuing medical transition, which may involve taking hormones and getting gender-affirming surgery.

    Access to gender-affirming medical care has been shown to reduce the risk of depression and suicide among trans youth and adults.

    To learn more about the trans community, visit resources from the National Center for Transgender Equality, the Trevor Project, PFLAG, and Planned Parenthood.

    If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • My dance school is closed for the summer, how can I keep up my fitness?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Once the end-of-year dance concert and term wrap up for the year it is important to take a break. Both physical and mental rest are important and taking a few weeks off can help your body repair and have a mental break from dance.

    If your mind and body are in need of an extended break (such as more than a few weeks), then it’s more than OK to take longer off, especially if you are training at a competitive or pre-professional level.

    There is benefit in enjoying other aspects of your life outside of dance such as spending time with family, friends and enjoying hobbies.

    Tatyana Vyc/Shutterstock

    A safe, fulfilling dancing life

    Creating meaning and value in life outside of dance and expanding sense of self can make it easier to lean into other aspects when experiencing change or difficult times during dance training such as being injured.

    Taking an extended break from dance training will, however, mean losing some fitness and physical capacity. When you return to dance your body will take time to return to full capacity again.

    Approaches such as being “whipped back into shape” can promote sudden spikes in training load (hours and intensity of training) which can increase the risk of injury. It is advised to gradually and progressively increase training load over time to allow the body to adapt and return to full capacity safely.

    A four-to-six week period of gradually progressing training load and introducing jumping has been suggested in dance settings.

    For dancers wanting to maintain fitness over the summer holidays, a great place to start is focusing on building a physical foundation.

    A teenage girl running.
    Exercise like running can help build a physical foundation. Jacek Chabraszewski/Shutterstock

    Building a physical foundation means focusing on targeted areas of fitness such as full body strength, cardiovascular fitness or stamina (such as skipping, cycling walking, running, swimming), flexibility, and some dance-specific conditioning (for example, calf rises for ballet).

    A good physical foundation will mean an improved capacity and fitness level so your body is ready to take on more challenging dance movements and routines once you return to the studio.

    Building full body strength at home or at the park

    A great place to start is by choosing movements that require your muscles to work to support your own body weight.

    Fundamental movements such as crawling (moving on the floor on hands and feet) and locomotion (travelling movements such as lunging, hopping, sliding) are great for developing body control, arm and leg stability and coordinated movement patterns.

    Below is a sequence that can be used as a warm up and even as a workout itself. The ten minute sequence is based on gross motor and fundamental movement patterns. It includes exercises that work through a range of joint movements and in multiple planes (forwards, sideways, rotating).

    Several exercises.
    This fundamental movement sequence can be used as a warm-up or a workout. Joanna Nicholas, CC BY

    Once feeling comfortable with the above fundamental movements, it is time to introduce body weight resistance exercises.

    Body weight resistance exercises can be beneficial for developing a strong foundation for dance movements such as jumping, landing, floorwork, partnering and aerial work.

    Exercises from the above sequence can be used to form a safe and effective neuromuscular warm up.

    Aim to include one exercise from each of the below movement categories (squat, horizontal push etc) to build your own workout.

    Aim to complete two to three sets (or rounds) of each exercise with about one minute rest between sets. An alternative is to complete one set of each exercise with minimal rest between, then complete a second or third time.

    If training with friends, you could set a timer and do each exercise for up to 50 seconds (instead of counting reps) and take ten seconds to transition to the next exercise.

    Depending on your level of strength you may need to do fewer repetitions and build up sets and repetitions overtime. After you have completed the body weight exercises complete a cool down including stretches for the upper and lower body muscles. Be sure to use a sturdy bar (such as an outdoor fitness station) for horizontal row and overhead hold.

    Exercises may need to be modified depending on fitness level and physical limitations such as injury.

    Body weight exercises.
    You can build your own full body strength workout using these movements. Joanna Nicholas, CC BY

    How often should I train?

    A common misconception in dance is that “more is better”. This belief can lead to dancers training long hours on most or all days of the week which can lead to overtraining, plateauing and increased risk of injury.

    Our bodies require sufficient time between training sessions to adapt and get stronger and fitter. The time between sessions is when our muscles and tissues repair and training gains are made.

    By incorporating adequate recovery (including sleep and downtime) and including rest days throughout the week, our bodies can gain the most benefits from training.

    A young woman reads a book.
    Rest days are important, too. Manop Boonpeng/Shutterstock

    Muscles can take up to 48–72 hours to recover from most types of strength-based exercises (the more intense the longer they’ll need to recover).

    Aerobic activity at low intensity, such as a brisk walk, can be done most days (24-hour recovery) while high stress anaerobic exercise such as high intensity intervals or sprints can take three days or more to recover from.

    Aim to spread training sessions out over the week and allow time to recover between sessions.

    Below is an example weekly schedule based on incorporating adequate recovery between sessions, and incorporating polarised training where some days are harder and others are easier.

    Seek guidance from your healthcare provider and/or an exercise professional prior to undertaking a new exercise program.

    Joanna Nicholas, Lecturer in Dance and Performance Science, Edith Cowan University

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

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