What could be more natural than a mother breast feeding her offspring. The act is not only one of providing vital, infantile nourishment, but one of essential mother and baby bonding, a natural force of nature that lasts a lifetime. In most cases this physical and biological function requires no nurturing, no encouragement or instruction.

However, in some mother and baby relationships, difficulties can arise. Although exact figures are difficult to ascertain, it is thought that, globally, between 5 and 10 percent of mothers experience some level of difficulty with breast feeding. The reasons for these difficulties are varied and numerous, thus requiring expert knowledge and skills to pin point and remedy.

Throughout millennia, mothers with breast feeding difficulties have sort answers from more experienced mothers, on the face of it, a logical thing to do. But with advice only being based on personal experience, and with no two people, or their experiences, being exactly the same, advice can become muddled, confusing and contradictory. 

Fortunately, in Thailand, this was recognized by Samitivej, at their Sukhumvit and Srinakarin Children’s Hospitals, internationally recognized by the World Health Organization and UNICEF. Each of these world class medical establishments now has their own dedicated lactation clinics for mother and baby, which have been officially acknowledged by the Ministry of Public Health as the first “Baby-Friendly Hospital” in the kingdom.

These specialist facilities focus only on the problems that some mothers experience with breast feeding. Firstly, this is done by understanding the exact nature of the individual mothers problem. Only through this expert, and exact assessment and diagnosis can successful remedies be administered.

Conditions that Cause Lactation Issues

Although all mothers are physiologically capable of breastfeeding, or lactation, there are those that encounter problems, to varying degrees. However, it is rare that a mother is unable to produce any milk at all. 

Stress is the number one reason for a reduction in the amount of milk a mother produces, and is not uncommon. Following the birth of a child, sleep patterns are disrupted, new mothers may worry excessively over their new offspring’s wellbeing, their environment or domestic situation. All of these factors, and many more, can lead to stress and adversely affect the mother’s milk production.

Hypoplasia, or more precisely, mammary hypoplasia is the most common cause of failed lactogenesis II. Hypoplasia is a condition whereby the development and production of tissue cells is muted. In the breast, this can lead to the insufficient production of milk necessary to give the required level of nourishment and physical satisfaction to baby.

Although mostly in older mothers, another fairly common medical issue that can impair the production of a mother’s milk is, mammary duct ectasia, sometimes referred to as periductal mastitis. With this condition, the central milk ducts become abnormally dilated, with signs of chronic inflammation and fibrosis. This can lead to the milk duct becoming blocked, resulting in an impaire4d flow of milk.

A hormone imbalance can affect a mother’s milk production. During pregnancy, and following the birth of baby, the mother undergoes an astonishing level of changes within the body, many of them hormonal. One imbalance that is not uncommon, is having a lowered level of the hormone prolactin. Prolactin, if produced by the pituitary gland at an insufficient level, will result in lowered levels of milk production.  

A Simple Matter of Knowledge

Very often problems with breast feeding are easily overcome. In many cases new mothers simply don’t have any experience of such matters. Often all mothers need is the imparting of the knowledge and wisdom of Samitivej Hospitals Lactation Clinic. 

The Lactation Clinic, with unparalleled expertise, are able to advise, guide, instill confidence and encourage mothers in the whole process of breastfeeding. The skills of the clinic’s teams, combined with compassion, understanding and empathy come together to create an effective, stress free program of treatment and guidance, all of which has led to unequalled levels of success.

Factors that May Preclude Breastfeeding

Although all mothers are physiologically capable of breastfeeding, there are situations where mothers, with medical advice, may need to preclude themselves from breastfeeding their babies. 

Such preclusions are made to protect baby from potential risks being transferred from the mother. Although, baby can, themselves, have conditions that make them unable to take breastmilk, such as galactosemia. 

Mothers infected with Human T-lymphotropic virus types I and II, or HLTV 1 & 2 will always be instructed by Samitivej Hospital’s Lactating Clinic experts not to breastfeed their babies. Unlike the human immunodeficiency virus, or HIV, types 1 and 2, HTLV is transmitted through breastfeeding, and not trans-placentally or as a result of delivery.

Additionally, the clinic will advise the same to mothers that has been diagnosed with, or is suspected of having, the Ebola virus. This virus, in babies under 12 months of age is fatal in 90% of cases, thus precluding mothers with the virus from breastfeeding is essential.

Following expert assessment by the Lactating Clinic professionals, mothers maybe told to temporarily refrain from breastfeeding for the wellbeing of baby. Certain prescribed medications and vaccinations can result in the temporary suspension of breastfeeding.

Brucellosis, a bacterial disease, can be passed on to baby through mother’s milk, as such, the mother will be required to cease breastfeeding if diagnosed with brucellosis, and until the disease has been successfully treated. 

Should a mother be undergoing treatment or diagnostics for a medical condition that requires diagnostic imaging via radiopharmaceuticals, then the specialists at the Lactating Clinic will ask for a suspension in breastfeeding.

An infection by the herpes simplex virus, or HSV, can cause breast lesions on one or both breasts. If both breasts are infected with the virus, mother will be required to suspend breastfeeding until free of the virus. Should only one breast be infected, with the infected breast suitable dressed and covered, mother can feed from the uninfected breast.

Mpox, or monkey pox, which was first diagnosed in humans in 1970, is no longer peculiar to the African continent. The transmission from person to person has now lead this viral disease to be found in the Western world and across Southeast Asia. The professionals at Samitivej Hospital’s Lactation Clinic will always preclude mothers from breast feeding their babies if diagnosed with this disease.

There are a number of health issues that may affect mother which will require her to express her milk, which can then be fed to baby, under the advice of the Lactation Clinic. These issues will include untreated tuberculosis. Usually after around 2 weeks of treatment and confirmation of being non-contagious, mother will be able to resume breastfeeding in the normal way.

Should mother contract chicken pox 5 days before delivery of her newborn, or within 2 days after the birth, the mother will be required to express milk with which to feed baby. This practice will need to continue until mother has been successfully treated and certified as non-contagious. 

The Lactation Clinics at Samitivej Hospital’s Sukhumvit and Srinakarin facilities are the country’s leaders in all issues relating to breastfeeding, for both the local, and ever increasing, foreign population. The Lactation Clinic is committed to the preservation and improvement of the wellbeing of all mothers and babies.