Maternal perceptions of insufficient milk supply in breastfeeding

Improving the duration of exclusive breastfeeding is a national and international priority. Insufficient milk supply is one of the most commonly cited reasons for early cessation or decreased exclusivity in women who have initiated breastfeeding. This paper is an integrative review of current research pertaining to perceived insufficient milk (PIM).

CINAHL, MEDLINE, and PubMed were searched combining "human milk" and "milk supply" and "perceived milk supply." Articles were limited to original research studies related to healthy, full-term breastfeeding dyads conducted over the past 10 years. Critical review indicated robust findings, limitations, and gaps in this body of literature.

A lot of women discontinue breastfeeding during the first few weeks of the post-partum period because of PIM and approximately 35% of all women who wean early report PIM as the primary reason. Many women utilize infant satisfaction cues as their main indication of milk supply and many researchers, clinicians, and breast-feeding women do not evaluate actual milk supply. The relationships between PIM and socioeconomic or demographic variables as well as early breastfeeding behaviors have not been adequately addressed in the literature.

Recommendations include improvement of maternal education about behaviors to ensure adequate supply, assessment of milk supply, and infant cues as well as further research into the root causes of PIM.

Practitioners involved with maternal child health can improve their care of women and infants by understanding the subjective nature and questionable accuracy of PIM and changing assessment of milk supply.