The desire to breastfeed one’s newborn baby has become the rule rather than the exception, at least in my experience in private practice. Most of the time, things work out very well for both mother and baby.  But sometimes, breastfeeding doesn’t work out well at all.  Milk production sometimes can lag behind the baby’s requirement for fluids and calories.  After a week or two (or more), inadequate milk production can cause a great deal of alarm, anxiety, sadness, and even guilt, especially among first time moms.  From there, it’s a short ride from attempting breastfeeding to abandoning it in favor of infant formula.

An interesting and important new study published last week in the journal PLOS ONE may shed light on why breast milk may come in faster for some mothers than others.  And the results show that problems with breast milk production, especially in the early days, have a biologic basis.  Robert Preidt summarizes and quotes one of the authors on this “exquisite portrait of human lactation”:

“This new study shows a dramatic switching on of the insulin receptor and its downstream signals during the breast’s transition to a biofactory that manufactures massive amounts of proteins, fats and carbohydrates for nourishing the newborn baby,” Nommsen-Rivers said in a medical center news release.

In previous research, Nommsen-Rivers found that new mothers with characteristics linked to poor glucose metabolism — such as being overweight, older or having a large baby — take longer to begin producing milk. This suggested that insulin was a factor in milk production.

“Considering that 20 percent of women between 20 and 44 are prediabetic, it’s conceivable that up to 20 percent of new mothers in the United States are at risk for low milk supply due to insulin dysregulation,” she added.


More studies are in the works:

Nommsen-Rivers and her colleagues are planning a study to determine if a drug used to control blood sugar in people with type 2 diabetes boosts insulin action in mammary glands and improves milk supply.

“The ideal approach is a preventive one,” she said. “Modifications in diet and exercise are more powerful than any drug. After this clinical trial, we hope to study those interventions.”


This is an important study.  If prospective or expectant mothers know there are things they can do to help themselves produce more milk when the baby arrives, or if they know there might be something they can take to do the same, then perhaps more women will attempt and succeed in nursing their babies in the future.

That would be a win-win!