Insufficient lactation


Insufficient lactation refers to the common clinical symptom that milk secretion of a nursing mother is insufficient to feed the baby. In some cases there may even be no secretion of milk at all. Ancient people named it as lack of milk and halted milk flow due to deficiency of qi and blood or to stagnation of the liver qi. It is clinically divided into deficiency and excess types.

 

Etiology and Pathogenesis

a) Deficiency of qi and blood: Milk is transformed from qi and blood, the origin of which are nutrient substances of food or the acquired essence. Either the weakness of the spleen and stomach or profuse loss of qi and blood during delivery may effect the formation of milk. Zhang Jingyue in his book Observations of Women points out that "the qi and blood in women's Chong and Ren Meridians turn into menses when it descends, and transform into milk when it ascends." The delayed or insufficient secretion of milk after delivery is due to the insufficiency of qi and blood. Those who have no milk secretion definitely suffer from the weakness of the Chong and Ren Meridians.

b) Liver qi stagnation: It is caused by mental depression after delivery impaired dispersing of the liver qi, disorder of qi and blood, blockage of the meridians, and obstructed flow of milk finally bringing on the insufficient lactation. The book The Literati's Care of Parents explains that "sobbing, crying, grief, anger, depression lead to obstruction of the milk passage."

 

Syndromes

Qi & Blood deficiency

Main manifestations: Insufficient secretion of milk after delivery or even absence of milk, or decreasing secretion during lactation period, no distending pain in the breast, pale complexion, dry skin, palpitation, lassitude, poor appetite, loose stools, pale tongue with little coating, weak and thready pulse.

Analysis: Because of the deficiency of qi and blood, the weakened transforming source of milk leads to scanty secretion without distension in breasts. Insufficient qi and blood makes pale face and dry skin. Palpitation ensues on malnutrition of the heart and blood. Dysfunction of the spleen and insufficiency of qi in the middle jiao give rise to lassitude, poor appetite and loose stools. Pale tongue and weak thready pulse are signs of deficiency of both qi and blood.  This is very common among new mothers.  After labour, Qi and blood have been consumed leaving very little to be transformed into breastmilk.  Continuous stimulation and not skipping feedings is very important here.

P/T – nourish Qi and Blood, promote milk production and secretion

Acupuncture

  • *SI 1, ST 36, BL 20, ST 18 (moxa), RN 17
  • excess blood loss- BL 15, 17
  • palpitations, shortness of breath- RN 6, MH 6
  • soft stool- RN 12, ST 25

Liver Qi stagnation

Main manifestations: Absence of milk secretion after delivery, distending pain in breast, mental depression, chest distress and hypochondriac pain, epigastric distension, loss of appetite, pink tongue and string - taut pulse.

Analysis: Liver carries out the dispersing function of qi. Mental depression after delivery impairs liver qi, which obstructs the milk flow, leading to the distending pain in the breast, and hypochondriac pain. Disharmony of the stomach causes epigastric distension and loss of appetite. String - taut pulse is another sign of stagnated liver qi.  The woman is stressed out, angry, irritable, depressed, the milk is thick, breasts are hard and in pain, stagnated flow of milk.  This pattern shows the formation of a plugged milk duct and may be turning to Mastitis if feverish feelings occur.

P/T – soothe Liver Qi, promote the flow of milk

Acupuncture

  • *SI 1, ST 18 (moxa), RN 17, MH 6, LR 3
  • chest/hypochondriac pain- LR 14
  • fever- LI 4, 11, DU 14
  • poor appetite- RN 12, ST 36

 

Notes

Since breast is where Foot - Yangming Meridian passes and ST28 is located on the Stomach Meridian of Foot - Yangming at the breast, ST28 is used here to restore the free flow of qi in the Yangming Meridian so as to promote the lactic secretion. RN17, the Confluential Point of qi, serves to regulate qi and promotes the flow of milk. SI1 is an effective and empirical lactogenic point. BL20, ST36 and SP6 are used to regulate and tonify spleen and stomach, promote the transformation of milk from blood. LR14 and LR3 are to remove stagnation of liver qi. MH6 is added to regulate qi flow in the chest and restore the free flow of milk.

 

Alternative Treatment Methods

  • auricular- chest, endocrine, LR, KI.  Try ear seeds.