You get what you expect- low milk supply and psychology
May 4, 2016
Today we're gonna talk about response expectancy theory. Oh no, I can already see your eyes glazing over. Stick with me on this one, please- it's super interesting.
Response expectancy theory is defined as the anticipation of automatic, subjective, and behavioral responses to particular situational cues (Kirsch, I. (1997). Response expectancy theory and application: A decennial review. Applied and Preventive Psychology, 6, 69-79.9).
Basically, what that means is that people's minds AND bodies react differently to situations, depending on what those people expect is going to happen.
For example, Dr. Irving Kirsch did an experiment with coffee (Kirsch & Wexel, (1988) Double-blind versus deceptive administration of a placebo. Behavioral Neuroscience, 102, 319-323). He asked his subjects how they expected a cup of regular (caffeinated) coffee to affect them. Would they feel energized?
He then had the people drink a cup of coffee and he recorded their changes in mood, motor task performance, and even blood pressure. The people responded exactly as they expected to react to a cup of caffeinated coffee- both mentally and physically.
But here's the interesting part- the coffee the people drank was actually decaf! So people's bodies reacted based on their expectations, not on the actual caffeine (or lack thereof) in the coffee.
Response expectancy theory is similar to the placebo effect, but it exists even in situations that have no placebo. A different study looked at nicotine withdrawal; all of the participants were given nicotine gum (Tate et al, Experimental analysis id the role of expectancy withdrawal. Psychology of Addictive Behaviors, 8, 169-178.) . Groups of patients were told to expect differing levels of withdrawal symptoms. The patients who were told to expect no withdrawal symptoms reported fewer symptoms- and if a group of participants were told to expect a symptom in particular, then they reported experiencing it (and no other groups reported that symptom).
I know what you're thinking..”Okay Sara, what does this have to do with breastfeeding and low milk supply?”.. Well my friends, A LOT!
Do you remember what you heard about breastfeeding before you ever tried it yourself? Did you hear other families talking about having a hard time making enough milk? Did you see articles in parenting magazines that told you how to AMP UP YOUR SUPPLY or warned you that 49% of mothers said low milk supply was their biggest "booby trap" or that you may have "less milk than the baby needs"?
Or did you see a TV talk show like The View when three of the four hosts said they had breastfeeding problems, including Elizabeth Hasselbeck saying "he couldn't get enough, and I didn't have it" and Shari Shepherd saying she couldn't produce breast milk?
I am NOT saying that all women can breastfeed, and I am NOT saying that low milk supply is a myth. I'm NOT discounting the stories of anyone who experienced low milk supply. My point is that when we hear about low milk supply over and over, response expectancy theory says that our bodies can respond in the way that we expect them to- by making less milk than we need.
It's a self-fulfilling prophecy, and we may be perpetuating this when we give well-meaning advice and warnings to others. Are we setting families up for failure?
Would we change how we talk about breastfeeding and nursing if we knew that our words may cause problems for the person who is listening to us?
What would happen if we made a concerted effort to discuss the positive parts of our breastfeeding experience AT LEAST as much as we warn about the negative parts?
Could a change of attitude help to change the breastfeeding rates in our country?