(From LEAVEN, September-October 1995, pp. 72)
For some women leaking is little more than an
occasional drop or two during breastfeeding;
for others it may be copious amounts--sometimes
at anything but opportune moments. Many times
mothers are given mixed messages about leaking.
If a new mother is leaking milk, we reassure
her that she has plenty of milk. We routinely
suggest that mothers can stop leaking by putting
direct pressure on the nipple, as if nursing
mothers can expect to leak. Moreover, how many
times do we hear from mothers who are sure that
their milk supply has decreased because they
no longer leak?
There are products on the market today, from
pads to special shells, designed specifically
to help with leaking "problems." Sometimes
the products themselves contribute to the problem
if they apply continuous pressure on or around
the nipples. However, the question remains,
is milk supposed to leak?
Research on over-active letdown raise questions
about leaking. One begins to wonder whether
leaking might signal potential problems or whether
there are times when women should, even need
to, leak milk. The search for more information
begins with THE WOMANLY
ART OF BREASTFEEDING:
A common occurrence while you are breastfeeding
is for milk to drip from one breast when baby
starts to nurse on the other. If your breasts
are very full or engorged, there is good reason
to let the milk come out rather than
hold it back. It is a great way to relieve
that full feeling.
Two important points are made:
first, that if the breast is very full, something
should be done; second, leaking is a "good"
solution. Perhaps this is the physiological
basis for leaking.
Jan Riordan and Kathleen Auerbach put it this
way in Breastfeeding and Human Lactation: "Leaking
milk in the early postpartum period may serve
as a 'safety valve,' since many women who have
recurrent mastitis often report never having
spontaneously dripped or leaked milk."
THE BREASTFEEDING ANSWER
BOOK also makes the connection between
the value of leaking and preventing mastitis.
Counseling the Nursing Mother says, "Milk
leaking from the breast can be caused by let-down,
overfull breasts, too much stimulation of the
nipple, over-production of milk or hormone imbalances."
Note that with the exception of letdown, all
other causes are not routine, acceptable reasons.
Often, leaking accompanies let-down, especially
in the early weeks of breastfeeding "while
mother and baby are becoming adjusted to one
another and until harmony develops between supply
and demand." A mother with less storage
capacity for milk in her breasts may also leak
more as her body attempts to produce the quantity
of milk demanded by her growing baby.
Perhaps leaking is helpful for the new baby
who is still learning how to nurse efficiently.
The release of the milk provides multi-sensory
input to remind him why he is there. He may
see the milk drip, it may dribble in his mouth,
he may smell it, or feel the wetness. Sensory
input is especially helpful for the sleepy or
What about leaking when a mother is shopping
and hears another baby cry? In a natural setting,
baby would be with his mother, so he could signal
that it is time to nurse. Of course, the reality
today is that many babies are not with their
mother every time they want to nurse, so women
are likely to leak. However, it could be argued
this still is not a situation that is supposed
to happen. There are some situations that cause
mothers to make, and consequently, leak copious
amounts of milk. Certain hormonal imbalances,
pituitary tumors, even medications can put milk
production in high gear. These require careful
investigation to discover the cause.
So, what does this entire matter mean in our
role as Leaders helping mothers? First, we need
to identify whether the leaking is bothersome.
To some women, leaking is reason enough to wean.
Those feelings need to be acknowledged before
giving her any suggestions on how to cut down
or eliminate the leaking. Second, it is important
that we look at how we cover the subject of
leaking at meetings, especially when pregnant
and new mothers are present. It is reasonable
to explain that many women do leak and that
it varies in duration and amount. Let mothers
know that if the leaking bothers them, they
are experiencing; it is a good idea to seek
help. There are suggestions that might eliminate
most of a mother's leaking. Mothers need to
know that it is not necessary to leak in order
to have a good milk supply, and conversely,
if they stop leaking, it is not always an indication
that the supply has dwindled. It may be a sign
that mother and baby are in accord with one
another, especially if the baby is healthy,
growing and contented.
Third, if a mother calls and mentions leaking,
it probably is bothering her. Using a combination
of HRE skills, breastfeeding basics and immediate
management techniques that include pressure
on the nipple and breast pads, we acknowledge
her feelings, educate her and give her help.
If a mother complains of truly excessive leaking,
then she may have a more serious medical condition
that requires input from her health care professional.
So, is milk supposed to leak? The more I think
about it, the more I am convinced that the answer
to that question is "probably not."
A more useful question might be, is milk supposed
to be able to leak. The answer to that one is
a definite "yes." Leaking can serve
useful purposes: encouraging the reluctant baby
to breastfeed, releasing
excess milk, reminding a mother that she needs
to feed her baby. Helping a mother understand
why she is leaking and giving her coping suggestions
might make for a much happier nursing couple.
to Breastfeeding Problem