This has been my experience. If you can see a mom prenatally and make her aware, you can also discuss breastfeeding as more than a method of getting a good food product into a baby, but as a connection between mother and child that is psychologically important. And I realize that some might not appreciate the comparison, but the connection through breastfeeding that goes beyond an exchange from mom to baby is similar to intercourse - which is more than conveyance of sperm for the purpose of reproduction! Many moms seem to appreciate this analogy. If a couple were having issues getting pregnant, you wouldn't tell them to forget about sex, now would you? Moms who are aware of the possibility of low supply might be able to line up donors to help with giving their babies human milk. I have a mom who has had a breast reduction which looks nice but appears may have limited function who has calculated how much milk her baby might need to be fully breastfed to 3 months and is actively soliciting potential donors. Now that's what I call planning ahead!
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Diana Cassar-Uhl
Sent: Tuesday, April 16, 2013 11:40 PM
Subject: Re: IGT/hypoplasia
Hi Tania,
I'm sorry that I can't give you a more comprehensive answer at the moment because I am under deadline to get my thesis (about the experiences of mothers with hypoplasia/IGT) submitted in time for me to graduate, but I wanted to let you know that in our study of mothers with hypoplasia, a very prevalent theme is that *they wish they had been told* their breasts might (or might not) show physical characteristics that may (or may not) be predictive of low milk output in lactation. Less than 1/5 of a sub-population of the sample (I'm only working with about half of the data for the thesis so this isn't a complete analysis but the N is sufficient) indicated that they would only want to be told about the concerning physical characteristics of their breasts after their breasts didn't want to make milk -- more than twice that percentage wanted to be told before pregnancy and about half of the respondents in this sample wanted to know either during pregnancy or immediately postpartum. The qualitative responses support these numbers, as well -- these mothers really want to know what you're seeing and they want to be counseled about why it's concerning, even if there ends up being no problem with milk production.
For the best evidence we have about the physical markers of mammary hypoplasia that may be predictive of lactation difficulty/low milk output,
see:
Huggins, K. E., Petok, E. S., & Mireles, O. (2000). Markers of lactation
insufficiency: A study of 34 mothers. *Current Issues in Clinical Lactation. *Sudbury, MA; Jones & Bartlett, 25-35.
A simple search will take you right to the full text of the paper online.
This blog post by an IGT mom is an excellent gallery of breasts of mothers who struggled with lactation and offers some insight into how varied their presentation might be.
http://diaryofalactationfailure.blogspot.com/2011/12/many-faces-well-not-faces-of-igt.html
I hope this is useful to you as you support this mother.
--Diana Cassar-Uhl, IBCLC (and hopefully soon-to-be MPH) New York, U.S.A.
> Date: Tue, 16 Apr 2013 10:03:02 -0400
> From: Tania Archbold <[log in to unmask]>
> Subject: Re: IGT/ hypoplasia
>
> Thank you. I was concerned about setting doubts in her mind. I did
> know about the spacing. Is it a definite sign? That is… if her
> breasts are not widely spaced is it very unlikely that she has IGT?
>
>
> Tania
>
> Tania Archbold B.Sc, IBCLC
> Mothers Nectar Lactation Consultant Services Guelph, ON Canada
> 519-400-7098
>
>
>
>
>
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