Gonneke you wrote:   "Of course she *can* be 1 of 5 in 1000 that are not able
to
produce any or enough milk, but I'd like to know that for sure before
medicating. Medication will depend on the reason for lactation insufficiency,
too."

I agree that before medication is discussed, one would have to take a
thorough history.  Where does this 5 in 1000 number come from?

Some years ago, I had the great pleasure of hearing Kathy Auerbach present a
lecture on breastfeeding research.  One subject she briefly touched upon was
that if a mother is "not" producing "any" milk, then this mother probably has
a pituitary tumor and that death is the usual result of such a tumor.
Therefore, I thought that what she was saying is that all women produce some
milk unless they are dying.  But maybe I misunderstood her lecture?

From that time on, it gave me a slightly different perspective when I had
mothers tell me that they had no milk or not enough milk with their last
baby.  I told mothers that having no milk was highly unlikely because they
were alive and talking to me.  And having just some milk does not preclude
them from having the breastfeeding experience.  While full-production of a
milk supply is vital for the health and growth of the infant, the physical
contact is just as vital for the emotional growth and development of the
mother and baby relationship.  We have devices like the sns's or lactaids(our
crutches in a manner of speaking) that can allow all mothers to experience
breastfeeding.  There is more to breastfeeding than producing milk.

What do these numbers mean in our current culture when breastfeeding is
sabotaged regularly?  Not enough milk is the formula mantra; a social
marketing idea so skillfully laid down in our culture that very few question
it.  So right from the start  a mother may have a mind set that can quickly
sabotage her best efforts to  fully breastfeed.  A few years ago, I did a
home visit for a mom who said she did not have enough milk for her baby.  She
was giving 2-3 ounces of formula daily and wanted to just totally breastfeed.
 Her baby was 3 months old and she was returning to employment in a few
weeks.  She had purchased a variety of very good electric and manual pumps.
And she wanted some help with pumping and storing milk, too.  When I got
there, she was nursing her baby and the baby had drifted off to sleep.  She
wanted to try pumping but was sure that since she had just nursed her baby
that  there wouldn't be any milk.  But we went ahead and pumped with an
electric pump.  She got 4 ounces.  She was delighted but wanted to know how
to use her manual pump, just in case.  She got another ounce of milk.  Then
the baby awakened and wanted to nurse.  The baby nursed for a short time and
then drifted back asleep.  We got on the topic of hand expression and she
wanted to know how to do it.  So I taught her hand expression and yes it
looked like close to another ounce of milk.  I think we both ended up
laughing and agreeing that low milk supply was not an issue.  Her belief that
she didn't have enough milk was based on the fact that the baby wanted to
nurse so often.   And,  the mother felt that her breasts were never full,
like in the early weeks.  So she started supplementing, thinking that her
milk supply was low.  But her milk supply was not low.  Her beliefs sabotaged
the breastfeeding. How many women end breastfeeding because of similiar
beliefs?  I truly wonder about the numbers of women who cannot produce enough
milk.
Valerie W. McClain, IBCLC

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html