Throughout history, a mother’s state of mind has been considered very influential on milk production. This is reflected in the popular wisdom of many cultures, where it is common to hear the warning, “Don’t upset a nursing mother or her milk will dry up.” Similarly, many “nervous mothers” have been told they won’t make enough milk because they’re too “high-strung. You may even have heard, “It’s all in your head.” While making milk is not all in your head, your thoughts and feelings do play a role in the bigger picture.

Mind over Milk or Milk over Mind?

The brain is wired in such a way that the nerve pathways for milk ejection run through the emotion-processing area of the brain. As a result, the responsiveness of your milk ejection reflex can sometimes be influenced by your emotional state or thought processes. A positive example of this is the way your breasts may start leaking when you hear your or another baby’s cry. Your maternal instinct responds to this basic cue and wants to nourish the child in need. On the other side of the coin is the self-conscious new mother nursing in public for the first time. Worried about drawing unwanted attention, she may experience slowed milk ejection, which may cause baby to fuss in protest and draw the attention she feared.

Research on oxytocin, the hormone of milk ejection as well as love and bonding, is still in its infancy. Not only is oxytocin subject to dual sources of physical and emotional stimulation, but it influences other hormones and is in turn influenced by them. Oxytocin influences prolactin, and prolactin may also play a role in the release of oxytocin. We don’t know how important this interrelationship is, but it’s possible that problems with oxytocin could affect production in subtle ways beyond milk removal.

As we explore how the mind can affect milk production, remember that your body is wired with overlapping “fail-safes” to help you succeed. The very fact that oxytocin release can be triggered through both nipple stimulation and thoughts or feelings shows that nature recognizes the importance of milk ejection. On top of that, the frequent surges of oxytocin from breastfeeding actually have a calming effect, making us less reactive to stress. If lactation was as fragile as many people seem to believe, the human race would never have survived. So as you consider the subtle role of the mind as a possible factor, keep in mind that nature wants you to succeed.

Potential Inhibitors of Milk Ejection

Phyllis was a high school teacher who had care fully prepared for her return to work. On her first day back, however, she called in a panic, reporting that very little milk was coming out when she tried to pump. Further conversation revealed that the curtains had been removed from Phyllis’s office, and she felt like a fish in a bowl on display for all the students walking by. No wonder she couldn’t pump milk! Once they discussed how to create more privacy, the milk started flowing and everything proceeded normally.

In this situation, Phyllis was worried that she was losing her milk, when in fact she was experiencing a temporary inhibition of her milk ejection reflex. Such short-term episodes rarely have a lasting impact on milk production. How ever, chronic long-term inhibition could reduce production over time because when less milk is removed on a regular basis, less milk is made in the long run. Had Phyllis not changed her uncomfortable environment, her milk supply might have been affected.

Unlike the more tangible physical or management-related causes of low milk production, the impact of psychological inhibition often lessens once it is identified. In most cases, it is possible to work through it by identifying or facing your stressors to understand them better and then making changes when necessary, such as Phyllis creating a more private environment. Even if the issues remain, understanding them will help you feel more in control, which may itself reduce your stress and allow the milk to flow more easily.

Painful Breastfeeding

Breastfeeding shouldn’t hurt! Chronic or severe pain while nursing can be a shock and a surprise something to postpone as long as possible. One mother told her lactation consultant, “I actually put my finger in to check her mouth-I was sure she had some sharp metal razor blades in there.” This mother understandably dreaded feedings even though she really wanted to breastfeed. The anticipation of pain can slow milk ejection temporarily, and inhibition can become chronic if breastfeeding is not fixed. When pain is an element of a low supply situation, it’s important to get help.

Birth Trauma

Childbirth is good work, but it’s often very hard work as well. At times, a difficult birth may become traumatic. Any severe psychological trauma that is related to the baby has the rare but possible potential to spark fear-related inhibition. Cynthia Good Mojab, M.S., IBCLC, a clinical counselor who specializes in the emotional needs and experiences of breastfeeding mothers, explains that a mother may be traumatized if she felt intense helplessness, terror, or horror during birth because she feared for her or her baby’s life, or if she experienced or witnessed serious injury during delivery. Birth may bring back memories of abuse or assault in childhood or adulthood. Or labor and delivery may have been challenging and joyous -yet circumstances surrounding birth, such as a family tragedy, may still have left you feeling traumatized.

The reasons may be varied, but the result is the same. A phenomenon that is beginning to be discussed is post-traumatic stress disorder (PTSD) due to childbirth, which is estimated to happen following 1.5 percent to 6 percent of all births. PTSD can occur alone, or simultaneously with depression or another psychological disorder. It may also be confused with other disorders such as generalized anxiety disorder. Because experiencing trauma is subjective and women are not routinely screened during pregnancy and labor or after birth, caretakers may not realize that a mother has been traumatized, let alone understand how much time may be required for recovery .

Women who suffer from PTSD related to childbirth may experience nightmares or flash backs, reliving whatever traumatized them again and again. Two frequent themes are the perception of extreme pain and a sense of loss of control. It is also common to feel emotional detachment from the event or family members and to be anxious and irritable, with outbursts of anger. Places and things that never bothered you before may suddenly trigger fear, putting you constantly on guard. Concentration and memory may be affected, and you may feel as if you are in a daze and life is not real. Emotions may be numb with little or no conscious love felt for your baby or for other family members and friends. This may even extend to a vague dis comfort when simply holding or breastfeeding your baby. You may find yourself going through the motions of mothering but feel secretly relieved when others take over care of the baby You may also experience intense guilt for your detachment. Fearful of reliving the memories, you may avoid the place at which the birth occurred and switch doctors. The normal lack of sleep that comes with parenting a newborn may be compounded by insomnia, Such symptoms may begin immediately or months or even years after the traumatic event Recognizing what is happening to you is the first step. Many people who have experienced a traumatic event .

Recognizing what is happening to you is the first step. Many people who have experienced a traumatic event .find it helpful to seek assistance from a mental health professional who is trained in women’s trauma issues. Search for someone who is knowledgeable about both trauma recovery and the importance of breastfeeding; ask your lactation consultant or a local La Leche League Leader whom she can recommend. Ideally, this person will be committed to treating you and your baby as an inseparable unit to be supported. Medications and Mothers’ Milk by Thomas Hale, Ph.D., is an excellent resource for evaluating any medications that may be suggested .

Grief and Loss

Judy contacted a La Leche League Leader because her baby was not doing well at the breast. He would latch easily and suck well but then fuss and didn’t seem to get much, even though she was clearly full of milk. Judy was encouraged to pump while continuing to work on breast- feeding and found that she was able to pump plenty of milk. This made the Leader wonder why the baby wasn’t able to transfer milk as easily. Following a hunch during a follow-up call, she gently asked her how she felt about being a mother. Judy burst into tears and shared that she was feeling guilty and unworthy of her new baby because of an abortion she had when she was younger. They talked about her pent-up feelings, and a referral was made for more in-depth help. Several days later, Judy called excitedly to say that baby had started feeding at the breast. To her delight, the milk had begun to flow easily, and baby was able to nurse to satisfaction.

 The loss of a baby whether by miscarriage abortion, stillbirth, disease, SIDS, or accident, is a profound loss in anyone’s life. In Judy’s case, she had suppressed remorse for a decision in her youth that was brought to the surface by the birth of her new baby, and that burden was subconsciously inhibiting her milk ejection as a consequence. Once she acknowledged her hid- den feelings and shared them openly, she was able to shed her burden and move more fully into her role as a nurturing mother.

Loss, especially loss that occurs suddenly and without warning, can be a great shock. We all deal with traumatic experiences differently, and at times nursing mothers have reported “drying up” that was more likely the inhibition of milk ejection. Such a reaction is usually temporary and doesn’t have to mean the end of breastfeeding. The best thing is to keep your baby close as you grieve and process your loss. It’s not uncommon for well-meaning people to offer to take him in the mistaken belief that this will reduce your stress. What they don’t understand is that babies can bring comfort and healing, and milk will soon flow again if nursing is maintained rather than put off.

History of Sexual Abuse

Jean contacted a lactation consultant while pregnant with her fourth child. With her first three children, Jean’s milk came in, and her breasts felt very full, but the milk did not come out, either for the babies or a pump. So she fed them formula but wanted to try nursing again with her fourth. While asking Jean about her experiences with her other babies, the lactation consultant learned that she had not experienced spontaneous labor with any of them, requiring induction with Pitocin each time. A previous consultant had raised the possibility that Jean had an oxytocin deficit, but because laboratory tests for oxytocin are uncommon, this could not be confirmed. Further questions revealed that Jean had experienced severe sexual abuse as a child that continued into adulthood with an emotionally abusive marriage. Jean consciously worked very hard as a parent to overcome the effects of her horrible childhood, yet it seemed clear that somewhere deep down, her mind and body were reacting to a past that she had not vet resolved. Once baby came, the same scenario repeated itself. Jean later sought counseling, and it was the opinion of her therapist, who had dual expertise in lactation and psychology, that the sexual abuse issues most likely did negatively influence her oxytocin release and milk ejection and possibly affected her birthing as well Hormone-releasing inhibitions as deep-seated as Jean’s are rare but do occur. Help for Jean came after she had completed her family, but she wished she could have worked on her issue beforehand.

Unlike Jean, who was very comfortable with the concept of breastfeeding on a conscious level, some mothers are deeply uncomfortable with the intimacy of breastfeeding and may not realize that it is a disturbing past physical experience that underlies the anxiety they now feel If you have been sexually abused, your natural concern for your baby’s health may be over shadowed by feelings of revulsion when he suckles at your breasts. You may also believe that the baby is rejecting you if he has difficulty latching or fusses when your milk flow is slow.

The experience of abuse may be only vaguely remembered. It may not even have been an actual sexual encounter so much as a physically threatening intimacy. In rare cases, a long- suppressed memory may evoke old feelings of threat or panic even though you cannot recall anything specific. Counseling may eventually reveal the underlying roots. A healthy breast feeding relationship can help a mother become comfortable with intimacy and human touch again, providing the opportunity to work through feelings and experience a greater degree of healing .

A woman who is being battered by her partner is also a trauma victim. During crisis, adrenaline begins to flow as her body goes into self-protective “fight-or-flight” mode. From nature’s stand- point, survival of the mother ranks higher than survival of the baby, and the body will inhibit other processes, including the delivery of milk to the baby, under such circumstances. When the danger has passed, milk will flow more easily again, but frequent battering could lead to chronic, extreme stress that in turn could affect milk production over time. If you are experiencing physical abuse, you must get help for your and your baby’s safety.

Harnessing Your Mind to Make More Milk

Are you dismayed to discover that your mind can affect your milk ejection? Don’t be, because this can be turned around to your advantage! By harnessing your thoughts, it’s possible to use your mind to stimulate more milk ejections, which allows baby to remove more milk and stimulate higher production. For some mothers, this may be very powerful, resulting in a considerable in crease in flow. For others, particularly those for whom milk production is low due to secondary reasons, psychological techniques may not have a great effect. Either way, it may be worthwhile to see if any of the following ideas strike a chord. Meanwhile, the deep relaxation will be beneficial .

The methods described are useful for both mothers who have experienced problems with milk ejection as a result of severe psychological stress as well as mothers who would like to explore psychological tools as an additional way to stimulate milk production. But keep in mind that these are meant to be used along with frequent, adequate milk removal. If milk is not being drained fully from the breast, no technique to improve milk production can be effective.

Create a Relaxing Environment

Your environment is important to your feeling of safety and peace. When you’re breastfeeding or pumping, try to minimize negative elements in your immediate surroundings. This may mean moving to a quiet room away from the rest of the family, especially anyone who is not entirely supportive of breastfeeding. Put on some music if you find it relaxing, Before you begin, take a few slow, deep breaths to clear your mind and body of any remaining tension. The influence of your environment on milk release is a factor that can change over time. Confidence is built with experience, and soon your mind will work effortlessly and efficiently in the busyness of day-to- day life.

Nurture Yourself

Do you find it difficult to relax? “Self-care” measures help you to relax more fully so that milk ejections come as easily as possible. Small treats like a nice hot cup of herbal tea, a bubble bath, or a hot shower when someone else is able to take over caring for the baby for a short while can help replenish emotional energy. Or you might find that it is soothing to get out in the fresh air and take a walk. Even stepping outside, looking up, and taking a few deep breaths of fresh air can make a difference. It is amazing how helpful even a few moments of self-care can be.

Distraction

Talking on the phone to supportive friends, reading books and magazines, watching television, and listening to the radio or music while nursing or pumping can be wonderfully effective in facilitating milk ejection by taking your mind off how much milk the nursing/pumping session has lasted. It can also serve to ease stress and relax your tension .

Condition Your Milk Ejection

Milk ejection can be conditioned to occur in response to a stimulus that you create through a routine. For example, sipping on a special beverage while you nurse may eventually be connected in your mind to breastfeeding, resulting in a milk ejection response whenever you drink it or perhaps even think about it. You can also learn to actively cause milk ejections by noticing what triggers them and then mentally picturing the trigger happening. For instance, if your baby’s cry is a trigger for you, then imagine that you hear your baby crying to be fed. Some mothers find that a more abstract image, such as a waterfall, helps to trigger a rush of milk. The more vividly you use your imagination to re-create the physical or emotional sensation of the trigger the easier it will become to stimulate your milk ejection response.

Visualization has been used to trigger milk ejections even when primary nerves have been damaged. The mothers with spinal cord dam age in that fascinating case study discussed in Blog 8 used mental imagery to induce milk ejection, resulting in significantly increased milk flow: One of the mothers in the study”… always breastfed in a quiet location that had no distractions. She began by counting to relax and then by mentally cycling through a series of images and thoughts that most commonly involved thoughts of loving and nurturing her infant. She reported recycling these image patterns several tines in the months that she breastfed, because they became less effective if used for several days in a row. Also she reported finding it useful to intersperse the periods of inducing [milk ejection] with a distracting task such as reading or watching television. Finally, she reported becoming better at inducing milk ejection] [with her third child] such that she could tolerate some distractions.

Relaxation

The very relaxation techniques that helped you cope through childbirth can now also help your milk to flow! There are two basic methods: physical relaxation and psychological relaxation. With the first, you concentrate on progressively relaxing all the muscles in your body from your toes to your scalp, while breathing deeply, The resulting deep muscular relaxation calms and clears the mind of concern, worry, aggravation, and stress. The second technique starts with the mind, allowing the physical relaxation to follow naturally. Envision anything that gives you a feeling of peace and well-being, such as lying in the sun or sitting beside a mountain lake.

Self-Talk

While learning to relax is an important part of helping milk ejection to happen, there are also other ways to use your mind to get the same results. One method in particular, known as “self- talk,” is based on the principle that we all have an ongoing internal dialogue. For example, when waking up in the morning, we think, “I really don’t want to get out of bed. I’m tired and I don’t want to change one more diaper.” Or, at the end of an enjoyable evening at the movies, “That was fun! I should get out more often.

Self-talk can be positive or negative and is influenced by what we hear around us and choose to internalize. Negative self-statements are usually in the form of phrases that begin like these: “I just can’t do …”; “If only I could or didn’t …”. “I just don’t have the energy…. ” This type of self-talk represents the doubts and fears we have about ourselves in general and about our abilities to deal with discomfort in particular. In fact, negative self-talk can worsen symptoms like pain, depression, and fatigue.

What we say to ourselves plays a role in deter mining our success or failure in becoming good self-managers. Learning to make self-talk work for you instead of against you can help improve your mental frame of mind and ability to relax Like all changes, this requires practice and includes the following steps:

  • Listen carefully to what you say to or about yourself, both out loud and silently. Pay special attention to the things you say during times that are particularly difficult. .
  • Work on changing each negative statement to a positive one that reflects your potential, strengths, and capabilities. For example, negative statements such as “I’ll never make enough milk” or “I can’t pump all the time so why bother” become positive messages such as “My breasts were designed to make milk” or “I can pump five times a day, and that is really good.”
  • Rehearse these positive statements, mentally or with another person, as a replacement of those old, habitual negative statements.
  •  Practice these new statements in real situations. Thi tience, will help the new patterns of thinking become automatic. s practice, along with time and pa –

Psychological techniques aren’t going to improve every situation, but they can’t hurt, and if they help, you’ll be glad you tried. At the very least, you’ll have done something that is good for your own well-being, and if baby benefits, too, all the better!

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