Insufficient milk supply is rarely a problem for the well-fed, well-rested, and unstressed mother. Sucking stimulates the flow of milk, thus feeding on demand should supply ample amounts of milk to the infant. If the baby continues to gain weight and length steadily, has at least six to eight wet diapers daily, and has frequent stools, the milk supply is probably adequate.
Sometimes an infant fails to thrive while seeming to nurse properly. A variety of circumstances can be explored as likely reasons for the failure.
Five the most common breast-feeding problems:
Retracted nipples – before feeding the infant, roll the nipple gently between the fingers until erect.
Baby’s mouth not open wide enough – before feeding, depress the infant’s lower jaw with one finger as the nipple is guided into the mouth.
Baby sucks poorly – stimulate sucking motions by pressing upward under the baby’s chin. Expression of colostrums often occurs, and the taste may stimulate sucking.
Baby demonstrates rooting but does not grasp the nipple, eventually cries in frustration – interrupt the feeding, comfort the infant. The mother should take time to relax before trying again.
Baby falls asleep while nursing – if the infant falls asleep early in the feeding, the mother should awaken the infant by holding him/her upright, rubbing his/her back, talking to him/her, or providing similar quiet stimuli. Another effort at feeding can then be made. If the baby falls asleep again, the feeding should be postponed.
If the cause of the problem cannot be identified or the defined problem cannot be corrected, it may be necessary to encourage the mother to use commercial infant formula for at least partial nutritional support of the infant.
Sometimes the infant may become intolerant or allergic to something the mother has ingested. Cow’s milk protein, notably casein, has been implicated along with peanuts. It is important to remove all suspicious foods from mother’s diet.
A thorough assessment of the maternal diet and health habits is always necessary. Women who consume diets low in vitamin B12, vitamin D, or iodine will produce milk with low levels. The result is failure to thrive in the breastfed infant.