How to Breastfeed: What You Need to Know About Low Milk Supply, Pumping and Your Mental Health
- Dr Natalie Hutchins
- Apr 14
- 5 min read
How to breastfeed episode introduction
Breastfeeding is one of the most charged topics for women that have just had a baby. The message that breast is best arrives long before the baby does, and yet the reality for many women is confusion, pain, and a sense of failure when it does not go as expected. If you’ve found yourself wondering why something described as natural feels so difficult, you are not alone. And you are not at fault.
The evidence for breastfeeding is genuine. There are real benefits for both mother and baby, and that matters. But those benefits exist within a context, and that context is often unsupportive systems.
Inadequate maternity leave, insufficient postnatal care, and a culture that expects women to snap back to who they were before birth. When breastfeeding breaks down in that environment, the responsibility does not lie with the mother; these are structural failings, not personal ones.
There is also a broader point that is rarely made explicitly: a mother’s mental health is the single most important determinant of family wellbeing. Not the feeding method. If breastfeeding is pushing you to a place where you cannot function, cannot rest, cannot be present, then no benefit it confers takes precedence over that. Stopping is not failure. It is a clinical decision in your family's best interest.
This week, Dr Mythili Pandi, integrative family physician and International Board Certified Lactation Consultant, joins me to navigate all of this.
Guest Bio
Dr Mythili Pandi is an integrative family physician and International Board Certified Lactation Consultant (IBCLC) based in Singapore, with over a decade of specialist lactation practice. She trained through the Breastfeeding Mother Support Group and has worked with mothers across the full spectrum of breastfeeding challenges, from early latch difficulties to complex supply issues and the transition back to work. Her approach integrates the clinical with the practical, and she is known for her ability to help mothers find a path that works for their lives, not just the textbook.
What We Cover
[00:04:02] The Physiology of Milk Production
• How pregnancy hormones prepare the body for lactation, from the first trimester through to birth.
[00:06:30] Why Milk Supply Can Falter: Birth Factors
• How a traumatic birth, lack of support, and stress hormones can interfere with lactation from the start.
[00:08:25] Latch, Positioning, and Knowing Baby Is Getting Enough
• Practical signs of a good latch: what the mother feels, what to listen for, and what to look for in the baby.
• Why milk transfer, not feeding duration, is the metric that matters.
[00:10:17] NICU, Separation, and Protecting Supply Early
• Why skin-to-skin contact is the single most important intervention when mother and baby are separated.
• When and how to start expressing if a baby cannot feed at the breast in the early days.
[00:13:08] Breast vs. Bottle: Expressed Milk, Formula, and the Middle Ground
• Why delaying bottle introduction to four to six weeks helps protect the mechanics of breastfeeding.
• The case for a pragmatic approach: a single drop of breast milk still counts, and it is never all or nothing.
[00:21:06] Tongue Tie: What It Is and When It Matters
• The mechanics of tongue tie and why it causes pain, not just poor milk transfer.
[00:24:49] Breast Anatomy, Surgery, and Milk Production Capacity
• What insufficient glandular tissue looks like and why breast size is not the determining factor.
• How breast augmentation or reduction surgery may affect milk production and what influences the outcome.
[00:27:40] Supplements, Medications, and the Low Supply Checklist
• The evidence (or lack of it) behind galactagogue supplements such as fenugreek.
• When prescription medications like domperidone are appropriate and how effective they are in practice.
[00:34:38] Going Back to Work While Breastfeeding
• Why night feeds matter more than most mothers realise, and the window when prolactin peaks.
• Practical preparation: double pumping, introducing a bottle or cup early, and building a workplace pumping routine.
[00:38:45] Myth-Busting, Weaning, and When to Stop
• Separating fact from fiction on breastfeeding and postnatal depression, IQ, and breast size.
• How to wean gently, and the message for mothers who were unable to breastfeed as they had hoped.
What You Will Learn
How does the body produce breast milk after birth?
Can a traumatic birth or caesarean section affect breastfeeding?
How do I know my baby is latching correctly and getting enough milk?
What should I do if my baby is in the NICU and I want to breastfeed?
Does tongue tie affect breastfeeding, and what can be done about it?
What are the signs of a low milk supply and how do I know if it is real?
Do breastfeeding supplements like fenugreek actually work?
How do I maintain my milk supply when I go back to work?
Key Takeaways
Milk supply is not just physiology, it is context. How your birth went, how supported you feel, how much rest you are getting: all of it matters. Struggling to feed is rarely your fault.
It is never all or nothing. Any amount of breast milk has value, and combining breast and bottle feeding is not failure. It is flexibility. A single drop still counts.
Get the right support early. An IBCLC can identify problems that are invisible to the naked eye: latch mechanics, anatomy, tongue function. Most women who struggle are not told this option exists.
Breastfeeding is more than milk. The skin-to-skin contact, the hormonal feedback, the sense of security it offers your baby: much of this can be preserved even if you cannot feed at the breast. A happy, supported mother is the most important thing.
Further Resources and Support
Find a Lactation Consultant
• International Lactation Consultant Association (ILCA) -- Find an IBCLC — global directory of accredited lactation consultants.
• International Board of Lactation Consultant Examiners (IBLCE) — the certifying body for IBCLCs worldwide, with a practitioner search tool.
Breastfeeding Support Organisations
• La Leche League International — peer-to-peer support, local groups, and evidence-based breastfeeding information worldwide.
• Breastfeeding Network — independent, evidence-based helplines and resources for breastfeeding mothers.
• World Health Organization: Breastfeeding — global recommendations and evidence on breastfeeding practices.
Postnatal Mental Health
• Postpartum Support International (PSI) — helpline, peer support, and provider directory for postnatal depression and anxiety.
• PANDA (Perinatal Anxiety and Depression Australia) — national helpline and resources for perinatal mental health (Australia-based, internationally accessible).
Tongue Tie
• Tongue Tie Support: tonguetie.net — information and support for families navigating tongue tie diagnosis and treatment.
Disclaimer
The content of this podcast and its accompanying materials is for educational and informational purposes only. It is not intended to replace the doctor-patient relationship, nor does it constitute personalised medical advice. The views expressed are those of the guests and host and do not represent the position of any institution or organisation. If you are affected by any of the topics discussed, please speak to your doctor or a qualified healthcare professional.
