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.

This time of year, many of us love to get out and spend time in nature. This may include hiking through Australia’s many beautiful national parks.

Walking in nature is a wonderful activity, supporting both physical and mental health. But there can be risks and it’s important to be prepared.

You may have read the news about hiker, Hadi Nazari, who was recently found alive after spending 13 days lost in Kosciuszko National Park.

He reportedly survived for almost two weeks in the Snowy Mountains region of New South Wales by drinking fresh water from creeks, and eating foraged berries and two muesli bars.

So next time you’re heading out for a day of hiking, what foods should you pack?

Here are my three top foods to carry on a bushwalk that are dense in nutrients and energy, lightweight and available from the local grocery store.

1. Muesli bars

Nazari reportedly ate two muesli bars he found in a mountain hut. Whoever left the muesli bars there made a great choice.

Muesli bars come individually wrapped, which helps them last longer and makes them easy to transport.

They are also a good source of energy. Muesli bars typically contain about 1,500–1,900 kilojoules per 100 grams. The average energy content for a 35g bar is about 614kJ.

This may be a fraction of what you’d usually need in a day. However, the energy from muesli bars is released at a slow to moderate pace, which will help keep you going for longer.

Muesli bars are also packed with nutrients. They contain all three macronutrients (carbohydrate, protein and fat) that our body needs to function. They’re a good source of carbohydrates, in particular, which are a key energy source. An average Australian muesli bar contains 14g of whole grains, which provide carbohydrates and dietary fibre for long-lasting energy.

Muesli bars that contain nuts are typically higher in fat (19.9g per 100g) and protein (9.4g per 100g) than those without.

Fat and protein are helpful for slowing down the release of energy from foods and the protein will help keep you feeling full for longer.

There are many different types of muesli bars to choose from. I recommend looking for those with whole grains, higher dietary fibre and higher protein content.

2. Nuts

Nuts are nature’s savoury snack and are also a great source of energy. Cashews, pistachios and peanuts contain about 2,300-2,400kJ per 100g while Brazil nuts, pecans and macadamias contain about 2,700-3,000kJ per 100g. So a 30g serving of nuts will provide about 700-900kJ depending on the type of nut.

Just like muesli bars, the energy from nuts is released slowly. So even a relatively small quantity will keep you powering on.

Nuts are also full of nutrients, such as protein, fat and fibre, which will help to stave off hunger and keep you moving for longer.

When choosing which nuts to pack, almost any type of nut is going to be great.

Peanuts are often the best value for money, or go for something like walnuts that are high in omega-3 fatty acids, or a nut mix.

Whichever nut you choose, go for the unsalted natural or roasted varieties. Salted nuts will make you thirsty.

Nut bars are also a great option and have the added benefit of coming in pre-packed serves (although nuts can also be easily packed into re-usable containers).

If you’re allergic to nuts, roasted chickpeas are another option. Just try to avoid those with added salt.

3. Dried fruit

If nuts are nature’s savoury snack, fruit is nature’s candy. Fresh fruits (such as grapes, frozen in advance) are wonderfully refreshing and perfect as an everyday snack, although can add a bit of weight to your hiking pack.

So if you’re looking to reduce the weight you’re carrying, go for dried fruit. It’s lighter and will withstand various conditions better than fresh fruit, so is less likely to spoil or bruise on the journey.

There are lots of varieties of dried fruits, such as sultanas, dried mango, dried apricots and dried apple slices.

These are good sources of sugar for energy, fibre for fullness and healthy digestion, and contain lots of vitamins and minerals. So choose one (or a combination) that works for you.

Don’t forget water

Next time you head out hiking for the day, you’re all set with these easily available, lightweight, energy- and nutrient-dense snacks.

This is not the time to be overly concerned about limiting your sugar or fat intake. Hiking, particularly in rough terrain, places demands on your body and energy needs. For instance, an adult hiking in rough terrain can burn upwards of about 2,000kJ per hour.

And of course, don’t forget to take plenty of water.

Having access to even limited food, and plenty of fresh water, will not only make your hike more pleasurable, it can save your life.

Margaret Murray, Senior Lecturer, Nutrition, Swinburne University of Technology

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