There is a question that ranks right up there with childbirth method, homeschooling, and whether or not you’ll let your children watch TV. Proponents of both sides promise you a happy, healthy child if you follow their advice, and a maladjusted, sickly child if you go with the other side. There’s been a lot of rhetoric spewed back and forth, along with condemnation, hurt feelings, and accusations. What am I talking about? The mother of all parenting questions: Are you going to feed your baby on a schedule (or “flexible routine”), or are you going to feed on demand (or “cue feed”)?

I used to find the debate frustrating and bewildering. I knew what I believed in my heart, but I was disturbed by so many other Christians who just as strongly believed something else. Then a couple of years ago, I stumbled across some information that finally helped me understand how people could have such enormously different experiences with feeding their babies.

Breastfeeding is a supply and demand process, and the way the “demand” is communicated to our bodies all depends on something near and dear to the hearts of countless women: storage space.

Think of it in terms of your kitchen counter. Imagine you and a friend are working in the kitchen serving up ice cream for a church party. You’re scooping out bowls of ice cream, and your friend is carrying the bowls to the hungry people. Well, imagine if every time you filled a bowl, it was instantly passed to someone, and maybe your friend was even standing there a moment, waiting for you while you scooped. You’d probably be working as fast as you could, dishing up ice cream at lightning speed. But what if your friend started walking around with a couple of bowls, and she couldn’t find anyone who needed any? You might notice that your filled bowls were starting to accumulate on the counter. In fact, you might be running out of space to put them, and by then, you certainly wouldn’t be feeling any pressure. You might look around, stretch, chat for a minute, etc., maybe even stop entirely, and have some ice cream yourself! Your “ice cream bowl production” slows to match the speed with which the bowls are removed from the counter.

It’s just the same with your breasts. It turns out that empty breasts “hurry” and make milk at a rate of about two ounces per hour, while full breasts slow way down and only make milk at a rate of 1/3 of an ounce per hour (and it’s a good thing they slow down production because otherwise we might explode). (Learn more here.) Put another way, empty breasts make six times as much milk in an hour as full breasts do. If your breasts are full, you have to empty them before you can make very much more milk. If healthy women are emptying their breasts regularly, they can have what is for all intents and purposes an unlimited supply (giving them the ability to nurse twins or even triplets).

Now, here’s where the storage space comes in. Imagine you’re back in the kitchen at your church party. How many bowls of ice cream are you going to fill before you give up on your friend and quit? It might depend on how much space you have on your counter. If you live in a farm house with acres of counter top spreading out before you, you might fill eight or ten more bowls before you decide to give up. But what if you live in a tiny newlywed apartment with barely enough space between the dish drainer and the coffee maker to cram in more than about two bowls? Are you going to fill ten? Not likely. You’ve got no place to put them.

Breasts are just the same. All women can make plenty of milk for their babies over a 24 hour period, but the amount that the breasts can hold without feeling uncomfortably full and needing to be emptied varies greatly. There is a 300% variation in milk storage capacity (counter top space) among women (Learn more here). We’ve all got a nice freezer, a Costco bag of plastic bowls, and a perfectly functional ice cream scoop, but how many bowls can sit on our counters before we stop filling them is not the same. If we don’t get the milk emptied out of our breasts, production will grind to a halt.

Now, think about something else. Chances are, all that “emptying” is going into your baby’s little tummy. That’s his food and drink for the day. So, that 300% variation also means something else. It means that when two babies nurse and take in almost all the milk each of their mothers has at any given time, the babies are actually getting different amounts of milk. Therefore, in order to take in exactly the same number of ounces of milk per day, two babies with different mommies are going to have to nurse two different numbers of times. It’s sort of like plate sizes at an all you can eat buffet. If your friend has a turkey platter for a plate, she’ll only need to go through the line once to get enough to fill her up. But if you have a salad plate, you’ll need to go through the line several times to get enough. And babies have different metabolic rates and activity levels, not to mention different sized little bodies! All these things have an effect on how many times they need to “go through the buffet line.”

OK, enter the schedule. Let’s say you buy a book that your friend said worked great for her, and the book says your baby should nurse every three hours or so, and that he shouldn’t need any more than that. You try your best to follow the book, but pretty soon, it appears that you’re not making enough milk. What happened? Storage space strikes again. Your breasts filled up, didn’t get emptied, and slowed production. If women have a 300% variation in milk storage capacity, then one schedule is not going to work for all of them.

This accounts for the wildly varying testimonies of different families trying to follow the same “book” schedules. I remember one father of a schedule fed baby who told me that the only problem he and his wife had was dealing with the jealousy of other parents when they heard how this dad’s baby slept through the night thanks to her wonderful schedule. But I have also read the words of other parents whose babies were on the exact same schedule who had very different experiences:

The reason why my baby was sleeping so long was her blood sugar was dropping so low she couldn’t wake up. She, in fact, was going into a coma. She may have had a pre-existing condition, but following Babywise (a scheduling book) reduced my milk supply and gave me a false picture of normal, healthy feeding and sleeping patterns, making her health problem truly dangerous. We almost lost our baby. –D.P.

After being admitted to the hospital, it took several specialists nearly 2 hours to insert an IV because his veins collapsed every time they inserted the needle due to his critical state of dehydration.

We can honestly say this was the hardest moment of our lives, knowing that our son was suffering and had been suffering for nearly three weeks because he had not been fed enough due to our foolish implementation of a feeding program taught by Prep (a scheduling program). –Jeremy, Lori & Son

We went to his 4-month appointment and he weighed in at 11 pounds, 6 ounces. He had lost nearly a pound in 2 months, where he should have gained at least 3.

I was horrified….

I still didn’t want to screw up my baby’s schedule. Mr. Ezzo (an author of scheduling books) promised me I’d have a demanding brat with “metabolic confusion” if I did. So I sadly sent my husband out for formula, and started pumping my milk to try and get my supply back up.

It didn’t work. Within a week I was feeding J. 75% formula. –K.M.

You can find links to more schedule feeding testimonies here. Of course, these are rather extreme cases, but they demonstrate graphically one end of the schedule response spectrum. And because there is such a spectrum, following a one size fits all schedule, no matter how well it worked for your friend, does involve risk. You have no idea whether your breasts will be able to store enough milk to continue to produce when feedings are spaced according to the schedule. You have no idea whether your baby will be like the daughter of the schedule feeding dad I knew or like one of the babies in the tragic stories I just quoted.

So, if your baby’s nursing needs can’t be predicted by an external schedule, how do you figure out when your baby needs to eat? Well, pretty much the same way you figure out when your older children need to eat. Not when they get so hungry that they’re crying (crying is actually a late indicator of hunger, according to the American Academy of Pediatrics Policy Statement, Breastfeeding and the Use of Human Milk) but long before then, when they either wake up, or when they say politely, “I’m hungry, Mommy, may I have a snack, please?” How does a baby who can’t talk tell you politely that he’s hungry? By making nursing cues, any kind of “increased alertness or activity, mouthing, or rooting,” according to the AAP, what we call at our house a “nursey face” –smacking his lips, opening his mouth, turning towards you, sucking on a fist or your shoulder or cheek. My current baby has always tried to throw herself down into nursing position when she wanted to nurse, taking a sudden sideways dive toward “lunch.”

Let your baby’s behavior tell you when it’s time to hit the buffet line, and keep that ice cream scoop going by keeping your counter tops clear.

Shortly after I began my own journey of breastfeeding, people started sharing with me stories of women, either themselves or friends, who “couldn’t” breastfeed because they didn’t “have enough milk.” At first I simply joined in the sorrow and horror, thinking this or that poor woman’s inability was an unfortunate fluke. But as time went on, and I heard more and more of these stories, I began to see some common threads. I also realized that it was more of an epidemic than a few flukes. If you’re a breastfeeding mother and have just discovered that your baby isn’t getting enough, PLEASE be encouraged. Don’t give up. Get help now.

In my experience, low milk supply is an extremely common reason for women’s giving up nursing. Despite the recent resurgence of support for breastfeeding, we still live in a culture that has been grossly affected by bottlefeeding ideas, and high on that list of ideas is the notion that many women aren’t able to produce enough milk for their babies. The belief that so many women fundamentally can’t breastfeed becomes a self-fulfilling prophecy as women who are faced with challenges just assume that they are one of these poor mommies who “can’t” and throw in the towel, when in reality, they could have been entirely successful if they had gotten help.

Women are willing to give up on their breasts extremely easily, far more easily than they would give up on other body parts like, say, their teeth. We would all find it sadly ridiculous for someone to say, “Wow, my teeth are full of cavities. I guess I’m not meant to use my teeth. I’d better have a feeding tube put in so I can bypass chewing.” Most of us would say, “Why are you giving up? Why don’t you go to the dentist and find out what’s wrong?” We should apply the same logic to our breasts. They are body parts, and like any other body part, if they aren’t doing their job, something’s wrong. For your baby’s sake (and your own), find out what the problem is.

It would really be very surprising if women’s bodies were as dysfunctional as they appear to be in this day and age. Think about it. Before formula, if a mother couldn’t produce enough milk, her baby died. Don’t you think the Lord would have designed a system that would work a lot more often than the one we seem to have? He would have. And He did. True, we live in a fallen world. And true, there actually are a few women with deformed breasts who really can’t produce enough milk. But they are very, very few and far between. (If your breasts look remotely normal, you probably aren’t one of them.) For 99.9% of women, breastfeeding challenges are not insurmountable. Don’t give up. Get help now.

A major issue is that it is most often the baby’s doctor who first recognizes that there’s a problem. (Praise the Lord for well-baby checks!) But unfortunately, the doctor equally often does something extremely unhelpful. After seeing that the baby is not getting enough, he immediately recommends formula. Why is this so unhelpful? Well, quite simply, breastfeeding is a supply and demand process. If your baby is getting formula, his demand for breastmilk will go down, and therefore, unless you are undertaking serious measures to prevent it, your supply will go down even further. What usually happens next is that women give up entirely. Supplementation, unless carefully managed, is the absolute worst thing you can to for low milk supply. Sadly, an awful lot of women assume that since a doctor told them to supplement, there must really be no other option.

You may be shocked to learn that your baby’s doctor is most likely not an expert on breastfeeding. (See this article for more information.) A pediatrician is an expert on childhood diseases, and most importantly for you right now, on infant wellness and proper growth and development, so you should absolutely take the news seriously that your baby is in trouble. However, a pediatrician is rarely in a position to tell you what to do about your low milk supply. Pediatricians are not specialists in breastfeeding. In fact they receive very little training in medical school on this topic. Some may have educated themselves, of course, but you cannot assume that just because the person is a doctor that he is qualified to diagnose and treat your milk supply problem. Indeed, pediatricians rarely try to treat low milk supply. Instead, they usually just give the common advice: “Supplement with formula.” Or even, “Switch to formula entirely.” This is not a treatment. It’s a bypass.

Now it may be the case that problems have gone unchecked for so long that by now you are producing almost no milk at all, and that your baby is truly starving to death. In that case, of course, you’re going to have to supplement. In fact, even if things are a lot less grim, you still might have to supplement some. But that is why it is imperative that you get the help you need to manage the supplementation properly so that you do not lose your milk supply completely, and so that you have a chance to build it back up again. I do not know your situation and cannot presume to tell you what the best treatment is in your unique circumstance. However, there are people who can tell you what to do. Don’t give up. Get help now.

Your first step should be to contact La Leche League . This organization is one of the world’s foremost authorities on breastfeeding, and offers support free of charge. The leaders you contact are mothers who have undergone extensive training (much, much more than the average pediatrician). They will be able to tell you if you can tackle the problem on your own with their help, or if things are so grave that you need to see a professional lactation consultant. A professional lactation consultant is someone with the letters “IBCLC” after her name. That stands for International Board Certified Lactation Consultant. Just as you would be leery of a “doctor” who was not an M.D., you should be leery of “lactation consultants” who are not “IBCLC.” The world is, unfortunately, full of them. There are a lot of “credentials” that you can get after attending a very short (as in one week) course. These women may not have the expertise you need. Find someone qualified to help you.

Why am I encouraging you to fight so hard to protect your milk supply? Formula is not good for your baby. It lowers his immune system. It causes his gut to stop functioning normally, making him prone to allergies. It even lowers his IQ and raises his risk of developing certain cancers, high cholesterol, obesity; and of dying of SIDS. You can learn more about all this here. Switching from breastmilk to formula is the equivalent of switching from fresh, organic produce, prepared by a gourmet chef to eating all meals at McDonald’s and popping a multivitamin. Formula is a processed food based either on highly allergenic cows’ milk or equally allergenic soy, with nutrients added in to mimic breastmilk. Problem is, we don’t even know all the good things in breastmilk. We’re discovering more and more all the time. So how could we possibly get all the necessary nutrients into a man made formula? Further, there are living cells in breast milk that we know benefit the baby’s immune system that we have no hope of getting into canned or powdered formulas. Formula use should only be temporary and only a last resort. Make a commitment to your baby that you will provide him with the best nutrition possible. Don’t give up. Get help now.

Breastfeeding has benefits for you, too. Every 12 months you breastfeed, your breast cancer risk is reduced by 4.3%. (Learn more here.) Breastfeeding also reduces your risk of ovarian cancer, lowers your stress level, increases your bone density, and helps you lose weight. (Learn more here). Make a commitment to yourself, too, to do what’s best for your own health.

Now if you lost your milk supply long ago with a previous baby, please don’t read this and feel guilty. As mothers, we all do the best we can with the information we have at the time. My purpose in writing this is not to make you feel guilty about the past, only resolved about the future.

Don’t take dire pronouncements lying down. Take your baby’s doctor seriously. Believe that your baby is in trouble. But don’t just supplement. Find out what’s wrong. For your baby’s sake, for your own sake: Don’t give up. Get help now.

Note: This post is not to be considered a substitute for the professional judgment of a medical doctor or International Board Certified Lactation Consultant.