Maternal Reported Indicators and Causes of Insufficient Milk Supply

Background: Although the breastfeeding initiation rate is high in China, exclusivity is low. Not having enough breast milk has been frequently reported as a reason for supplementing and weaning. Objective: The objective was to explore maternal perception of indicators and causes of self-reported insufficient milk supply (IMS) among a sample of southwestern Chinese mothers. Methods: This was a cross-sectional study, conducted in a hospital in Chengdu, China. Results: The majority of mothers were of Han ethnicity and primiparous. Most initiated breastfeeding (n = 325, 95.3%). Among mothers who had weaned by the time of questionnaire completion, more than half (n = 52) reported IMS as a reason, and 53.8% of these mothers reported this occurring during the first 2 days postpartum. Mothers often identified IMS by using less sensitive indicators of adequate intake such as receiving a hungry look from the infant after nursing (34.6%) and not feeling the presence of milk (28.8%). More sensitive indicators of adequate intake, such as the number of wet/soiled diapers, were not reported. More than a third of mothers (39.2%) could not express a reason for the occurrence of IMS. Among those who identified reasons, nearly one-fourth of mothers attributed IMS, at least partially, to dietary factors such as poor appetite (23.5%). Conclusion: Self-reported IMS appears to be a common barrier to breastfeeding continuation among this sample of Chinese mothers. Culturally appropriate intervention, designed to inform mothers how to correctly identify and address IMS, might be an effective strategy to support optimal infant-feeding behaviors in China.