Tuesday, November 16, 2010

New Risk for Low Milk Supply: Alcoholism in the Family, von Bunge, Mennella, MOBI

I would like to introduce you all to my new hero from the 19th century, a brilliant biochemist who laid the foundation of nutritional science and whose work is still relevant today, Gustav von Bunge (1844-1920). Please enjoy this biography, and be amazed that one man can achieve so much that is so meaningful!  

In 1907, towards the end of his life, von Bunge published a remarkable study (thankfully I am fluent in German) that links alcoholism in the family to low milk supply. In this study, von Bunge shows  results from a survey of more than 1600 women that spanned several European countries. Remarkably, he relates that in households where the father is an extremely heavy drinker, huge percentages of  daughters experience true low milk supply (40% compared to 3% in families with no heavy drinking). He also shows that low milk supply can be inherited, and that the granddaughters of heavy drinkers also tend to have problems.

In the decades that followed, von Bunge's correlation between alcoholism and low milk supply was not taken very seriously, and low milk supply was said, if anything, to be the result of the poverty and poor nutrition. Furthermore, von Bunge included in "low milk supply" not only those mothers who consistently had low secretion, but also those who did not breastfeed for more than nine months. The assumption was that if a mother weaned so "early" she must be struggling to make breastfeeding work. 

However, I recently felt compelled to take von Bunge's study more seriously when I saw a new study by Julie Mennella and Marta Yanina Pepino titled "Breastfeeding and Prolactin Levels in Lactating Women with a Family History of Alcoholism."

Briefly, Mennella and Yanina show that women with a family history of alcoholism have a "blunted"  prolactin response to the removal of milk from the breasts. Familial alcoholism is identified as a risk factor for breastfeeding problems. The mothers in this study, for instance, breastfeed more frequently than the "controls." This is probably an instinctive reaction: if you have less milk production per feed, more frequent feeding can make up the difference.
It took me a couple weeks, but I finally got up my courage to ask at our MOBI group if our mothers with low supply have alcoholism in their families. Unbelievably, nearly all of our mothers raised their hands. We conducted a spontaneous survey and found that the most common denominator was the maternal grandfather.

Is alcoholism in the family a risk factor for low milk supply? It appears to be so. More research is of course needed.

The good news is that this is the best of times to be aware of risk factors, because there is so much information and help available compared to only a decade ago. Having risk factors does not spell out failure. It does however signal the need to be prepared so that you can meet and overcome the problems when they arrise. See "Making More Milk," by Marasco and West, and my own book, "Mother Food," for starters.