Dear Friends:
    Anne Hinze asks about counseling the pregnant woman who looks like she 
won't make much milk.
    Derrick Jelliffe MD was, as far as I know, the first to say that 
breastfeeding is a confidence game. I want the mothers' confidence to be at the 
highest level.
    I say go for it all, keep the baby s2s after birth, bf as much as 
possible. Women will have colostrum. (I've not met a woman yet that didn't have 
Lactogenesis I. What are other's experience here?)
    The key will be if lactation progresses to stage II. Make sure the mother 
knows to look for poop color changes (Shrago published a nice article about 
this, and the Diaper Diary is a lovely visual to illustrate it), with the goal 
of yellow poops by day 5-7. Make sure the baby is weighed twice the first 
week, naked on a calibrated scale, and that the mother knows to expect some weight 
loss and then to see gain after day 4-5.
    This is the follow-up that ALL mothers in the US need, because giving 
birth in the US is a risk factor for premature weaning and/or low supply. No one 
mother is singled out with this practice.
    However, the healthcare professionals working with this mother are aware 
that she could have some impairment to lactogenesis II; what we know as 
practitioners we don't necessarily have to share with mothers. The organ  we are 
targeting is her brain, the master endocrine gland of all.
    warmly,
 
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
_http://www.breastfeedingalwaysbest.com/_ 
(http://www.breastfeedingalwaysbest.com/) 
www.myspace/AdonicaLee



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