Dear Lactnetters,
     I have spent most my career working with women that have had a history of 
infertility or some kind of problem with the pregnancy or delivery.  So I have seen 
my share of women with breast hypoplasia.  I would like to tell you about case that
I was involved with.  A barely term infant who was less than one week was admitted to the
NICU.  The baby had seizures, elevated sodium and hypoglycemia.  The parents requested to 
see lactation.  I was helping the mother (who was a primip) to learn how to pump and was gathering 
a history.  Mom had no breast changes during pregnancy and since delivery.  She had one prominent 
vein in each breast and tiny breasts even though she was overweight.  She had a small amount
of glandular tissue in both breasts in the upper outer quadrant.  Mom pumped about 10 ml after
4+ hours since breastfeeding.   This baby did latch and nurse vigorously from birth.  
     I remember mom telling me that she knew that her breasts didn't look like other women's
breasts but her doctor didn't say anything about her breasts when when she said she wanted to
breastfeed her baby.  She said "I thought they must be OK then." 
     These parents were intelligent and had done some additional reading on breastfeeding
during the pregnancy and would have done well in a normal situation.  They did hear occasional swallowing
and didn't understand that decreased stooling was a warning sign.  Their baby will have seizures and
a life long neurological deficit.  The mom continued to pump and did produce about 8 oz/day.  Mom did 
not want to breastfeed.
    I do feel that doctors and nurses do need additional education and need to understand 
that additional early follow-up is required.  I was the first LC that the parents has met.
Bad things can happen when breastfeeding doesn't work and professionals don't provide adequate
information and support.  
     Sincerely,  Rachel Wahl RN IBCLC           
 
   
 
Yeah and the most common reason for weaning is low milk supply...having
given birth to a baby is a risk factor for this. So lets tell every woman
who we see that 20+% of women are unable to make sufficient milk for their
babies and having just given birth to a baby places them at risk of being
unable to nourish their baby.

Honestly, I am really sick of this because for such a long time lactation
consultants and lay breastfeeding counsellors were trained to effectively
tell all adoptive mums that they could not make enough milk for their
babies. What was the basis of this. Was it in the research? No. But was it
believed by LCs and BF counsellors? Yes. And did mothers believe them and
did it become a self fulfilling prophecy. Yes.

Karleen Gribble
Australia


 		 	   		  
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