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  3. Lifestyle and Medical Factors That Reduce Supply
Course Content
Why Breastfeeding Matters (10 minutes)
Health and developmental benefits for infants Maternal benefits (physical and mental) Economic and community-level advantages Common myths and culturally specific misconceptions
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Health & Developmental Benefits for Infants from Breastfeeding
Maternal Benefits of Breastfeeding (Physical and Mental)
Economic and Community-Level Advantages of Breastfeeding
Common Myths and Culturally Specific Misconceptions about Breastfeeding
Newborn Feeding Cues & Anatomy (20 minutes)
Early vs. late hunger cues and what they mean Normal newborn feeding patterns and stomach capacity Brief breast anatomy (lobes, ducts, nipple, areola) in plain language Signs of effective feeding (swallowing, contentment, diaper output)
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Early vs. Late Hunger Cues in Infants
Normal Newborn Feeding Patterns and Stomach Capacity
Breast Anatomy (in Plain Language)
Signs of Effective Feeding in Breastfed Babies
Positions & Achieving a Good Latch (40 minutes)
Position options: cradle, cross-cradle, football/clutch, side-lying Stepwise approach to help baby latch (prepare — attach — assess) Signs of a good vs. poor latch (comfort, nipple shape, audible swallowing) Small-person adaptations (premature, small mouth, tongue-tie considerations) Safe positioning for mothers with C-section recovery
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Position Options for Breastfeeding
Stepwise Approach to Help Baby Latch
Signs of a Good vs. Poor Latch
Small-Person Adaptations in Breastfeeding
Safe Positioning for Mothers with C-Section Recovery
Protecting & Building Milk Supply (25 minutes)
Establishing supply in the first days and weeks (frequency, skin-to-skin) Night feeds and cluster feeding explained Lifestyle and medical factors that reduce supply (e.g., certain medications, stress) Relactation and increasing milk supply safely Nutrition and hydration myths vs. evidence
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Establishing Milk Supply in the First Days and Weeks
Night Feeds and Cluster Feeding
Lifestyle and Medical Factors That Reduce Supply
Relactation and Increasing Milk Supply Safely
Nutrition and Hydration Myths vs. Evidence in Breastfeeding
Expressing & Storing Breastmilk (20 minutes)
Hand-expression steps and common mistakes Choosing and using pumps (manual vs. electric) — practical tips Safe collection, labeling, storage, thawing and warming guidelines (low-resource options included) Cleaning and hygiene for bottles and storage containers Feeding expressed milk to infant (cup, spoon, paladai, bottle considerations)
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Hand-Expression Steps and Common Mistakes
Choosing and Using Breast Pumps (Manual vs. Electric)
Safe Breast Milk Handling
Cleaning and Hygiene for Bottles and Storage Containers
Feeding Expressed Milk to Infants
Common Problems & Practical Solutions (25 minutes)
Causes of sore nipples and immediate relief techniques Managing engorgement and preventing blocked ducts Recognising mastitis vs. normal engorgement and when antibiotics may be needed Low weight gain: assessment steps and feeding plan adjustments Non-judgmental approach to supplementation and safe short-term options
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Causes of Sore Nipples and Immediate Relief
Managing Engorgement and Preventing Blocked Ducts
Recognising Mastitis vs. Normal Engorgement
Low Weight Gain — Assessment and Feeding Plan Adjustments
Non-Judgmental Approach to Supplementation
Returning to Work or School; Feeding Outside the Home (15 minutes)
Creating an express-and-feed routine (timing, containers, transport) Practical storage and transport tips for different commute types Rights and workplace basics (general guidance; encourage local legal verification) Communicating with caregivers and preparing safe feeder notes Emotional coping and practical fallback plans
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Creating an Express-and-Feed Routine
Practical Storage & Transport Tips for Expressed Breast Milk by Commute Type
Rights and Workplace Basics for Breastfeeding Mothers
Communicating with Caregivers and Preparing Safe Feeder Notes
Emotional Coping and Practical Fallback Plans
Special Situations (20 minutes)
Feeding preterm or low-birthweight infants: kangaroo care, cup or tube feeding basics Managing twins/multiples: tandem feeding tips and time-saving routines Mothers on medication or with infectious illness: how to check drug safety and local guidelines (HIV, TB, etc.) Using donor milk or milk banks (where available) — safety basics
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Feeding Preterm or Low-Birthweight Infants
Managing Twins/Multiples — Tandem Feeding Tips and Time-Saving Routines
Mothers on Medication or with Infectious Illness — Drug Safety & Guidelines
Using Donor Milk or Milk Banks — Safety Basics
When to Seek Help & Building a Support Network (15 minutes)
Red flags for baby and mother (e.g., poor weight gain, fever, severe pain) Where to seek help: clinic, CHW, lactation consultant, emergency care Building a support network: partners, family, peer counsellors, community groups Using telephone/text supports, community groups, and referral pathways
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Red Flags for Baby and Mother
Where to Seek Help for Breastfeeding Challenges
Building a Support Network for Breastfeeding Mothers
Using Telephone/Text Supports, Community Groups, and Referral Pathways
Wrap-up, Resources & Final Assessment (15 minutes)
Key takeaways and common pitfalls to avoid Next steps: seeking local support, advanced training options How to use course materials beyond the course (groups, sharing, peer support) Final 20-question multiple-choice quiz (80% pass mark)
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Key Takeaways and Common Pitfalls to Avoid
Next Steps — Seeking Local Support & Advanced Training Options
How to Use Course Materials Beyond the Course
Final 20-question multiple-choice quiz (80% pass mark)
How to Breastfeed — Self-Paced, Evidence-Based Course for African Moms

Introduction

While most mothers are biologically able to produce enough milk, certain lifestyle habits, medical conditions, and medications can lower supply. Knowing these helps mothers prevent or address challenges early.

1. Lifestyle Factors

  • Infrequent or timed feeds → Skipping or spacing feeds too long reduces stimulation.

  • Stress, fatigue, or anxiety → High stress hormones (like cortisol) can interfere with milk let-down.

  • Smoking or alcohol use → Both can lower milk volume and alter taste, reducing baby’s intake.

  • Excessive caffeine → Large amounts may cause fussiness in baby and reduce feeding effectiveness.

  • Poor nutrition or dehydration → Severe restriction can impact supply, though mild variations usually do not.

2. Medical Factors

  • Retained placenta fragments → Delay milk “coming in.”

  • Hormonal conditions:

    • Polycystic ovary syndrome (PCOS)

    • Thyroid disease (hypo- or hyperthyroidism)

    • Diabetes or insulin resistance

  • Breast surgery or injury → Can reduce glandular tissue or damage ducts/nerves.

  • Insufficient glandular tissue (IGT) → Rare condition where breasts do not develop enough milk-making tissue.

  • Severe postpartum hemorrhage → Can damage the pituitary gland (Sheehan’s syndrome).

3. Medications That May Reduce Supply

(Always consult a health professional before stopping any medicine.)

  • Hormonal birth control — especially those containing estrogen.

  • Decongestants (pseudoephedrine) — can significantly lower supply.

  • Some antihistamines (diphenhydramine, chlorpheniramine).

  • Diuretics — increase fluid loss and may reduce supply.

  • Certain migraine medications (ergotamine, bromocriptine).

4. Prevention and Support

  • Feed or express often (8–12 times daily).

  • Manage stress with rest, support, and relaxation techniques.

  • Check medications with a breastfeeding-friendly resource (e.g., LactMed).

  • Seek medical help if milk seems persistently low despite frequent feeds.

End of Lecture Quiz

Q1. Which lifestyle factor is most likely to reduce milk supply?
A. Eating spicy food
B. Drinking 1–2 cups of tea per day
C. Skipping or spacing out feeds too long
D. Wearing comfortable clothing

Answer: C. Skipping or spacing out feeds too long
Rationale: Milk production depends on frequent stimulation and removal.

Q2. Which type of birth control is most likely to affect milk supply?
A. Copper IUD
B. Progestin-only mini-pill
C. Estrogen-containing contraceptives
D. Barrier methods

Answer: C. Estrogen-containing contraceptives
Rationale: Estrogen can reduce milk production, especially in early months.

Q3. True or False: Stress completely stops milk production in all women.
Answer: False
Rationale: Stress mainly affects let-down (milk release), not production itself, but chronic stress can lower supply indirectly.

Curated Online Resources

Key Takeaways

  • Milk supply is primarily driven by frequent, effective milk removal.

  • Lifestyle factors like stress, smoking, and skipped feeds can reduce supply.

  • Medical conditions (thyroid disease, PCOS, retained placenta, breast surgery) may play a role.

  • Certain medications — especially those with estrogen or pseudoephedrine — can lower supply.

  • Early support and evidence-based guidance are key.

Call to Action

  • Mothers: Feed often, care for yourself, and check with your provider about any medications.

  • Health workers: Screen for lifestyle and medical risks when supporting mothers with low supply.

  • Communities: Reduce stigma and provide rest, nutrition, and emotional support for breastfeeding mothers.

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