Online Program

Perceived milk insufficiency: A systematic review and synthesis of the literature

Tuesday, November 5, 2013

Regina Roig-Romero, MPHc, IBCLC, Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Background: Concerns about inadequate milk production are among the most commonly cited reasons for early weaning by breastfeeding women. While many studies identify perceived milk insufficiency (PMI) as a common problem, and some address why women lack confidence in their milk production, PMI itself has not been adequately analyzed as a discrete entity. The purpose of the current study is to synthesize the literature on PMI and arrive at a definition that is both theoretically sound and clinically practical.

Methods: Database searches were performed in Highwire, PsycINFO, MEDLINE, Pubmed, and the Cochrane Library using search terms “perceived”, “insufficient”, “insufficiency” and “milk” combined with breastfeeding/breast-feeding/breast feeding. Peer-reviewed references from relevant studies were also searched. Included studies were published in English from 1991-2012.

Results: Approximately fifteen (15) studies will be included in the review. Initial analysis suggests that the perception of inadequate milk production is more behaviorally-related than physiological, and occurs when infant suckling demands exceed the amount of time and effort that women feel able to invest in breastfeeding.

Conclusions: 1) Better anticipatory guidance during pregnancy could potentially reduce the incidence of PMI 2) low self-efficacy and insufficient time/social support play significant roles in its development 3) PMI can best be addressed through counseling individualized to women's concerns about the demands of breastfeeding and their milk production.

Learning Areas:

Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Define perceived milk insufficiency. Discuss the role of health care professionals when assisting women experiencing perceived milk insufficiency.

Keyword(s): Breastfeeding, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Senior Lactation Consultant (IBCLC) for the public health department at the WIC program in Miami Florida since 1996; I have served thousands of women experiencing perceived milk insufficiency, the subject of this presentation. In 2011, I took the lead role in implementing a workplace lactation support program for the health department's nearly-900 employees. In 2013, I will complete a Master of Public Health degree in Health Promotion and Disease Prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.