Two new studies show breastfeeding problems are common - and fixable   

Most new moms start out planning to breastfeed their babies. But when they encounter difficulties early on, many get frustrated and abandon the whole idea.

Two new studies from Cincinnati Children’s help explain why so many new moms get off to a difficult start. They also suggest ways to make breastfeeding experiences more successful.

The early days are crucial  

The first study, published this month in Pediatrics, reveals that 92 percent of new moms reported at least one breastfeeding concern within three days of giving birth.  And when new moms struggle early, they are 10 times more likely to give up on breastfeeding, says Laurie Nommsen-Rivers, PhD, who led a team of researchers in the study.

More than half of the 532 moms interviewed in the study said their main difficulty was getting their babies to “latch on” to the breast.  Other common concerns were pain with breastfeeding and an insufficient supply of milk.  Each mom was interviewed six times over several weeks. The moms who reported problems in the first week or two after giving birth, especially concerns about how the baby was feeding at the breast (“latching on”) or how much milk they were making, were most likely to stop breastfeeding. 

“This may be related to the fact that these interviews captured a time when there is often a gap between hospital and community lactation support resources,” Nommsen-Rivers says.

Better breastfeeding education, peer support, and professional lactation support in the first few days at home could make a critical difference in successful breastfeeding, she says.

Insulin levels can affect milk supply  

In another study, published in July in PLOS ONE online, Nommsen-Rivers and a colleague at the University of California - Davis discovered a connection between insufficient milk production   and how a mother’s body uses insulin.

Insulin is a hormone best known for regulating blood sugar. But it also plays an important role in regulating the metabolism of proteins and fats. Using gene sequencing technology, the researchers found that mammary glands are especially sensitive to insulin when lactation begins.

This suggests that mothers who are insulin-resistant may not secrete insulin fast enough to quickly build up an abundant milk supply. 

Patience and support are key

So far the studies have involved only a small number of women, says Nommsen-Rivers, but the findings suggest that insulin-resistant and pre-diabetic mothers can breastfeed – it may just take a little longer for their milk production to be adequate. She notes that it is especially important for these women to have professional support when starting to breastfeed.

“It’s crucial for mothers concerned about their milk supply to be under the care of a healthcare professional knowledgeable in breastfeeding management, such as the experts available at Cincinnati Children’s Center for Breastfeeding Medicine,” Nommsen-Rivers says.

The researchers plan a clinical trial of a diabetes drug used to control blood sugar to see if it improves insulin activity in the mammary gland and increases the milk supply.