Kristen,
What I tell mothers is two-pronged. First, I describe back to them my
assessment of their physiology and the results of a test feeding, including
the relative risk for poor outcome. Then I explain to them the findings of
Huggins, Petok and Mireles' study that with aggressive pumping, almost all
the women at risk produced more milk, though how much more was very
individual. I also share my experience with past similar clients. I try to
give them a realistic appraisal of their situation, then offer them the
opportunity to find out (over 4-8 wks) via pumping and possible
galactogogues what their potential might be. I also tell them about nursing
supplementers, pro's and con's. Each mom is able to weigh the work and
expense with the risks and benefits, and decides how she wants to proceed. I
support her in whatever decision she makes, and encourage her that whatever
milk she is able to give baby is of value. I try hard not to push her in a
direction, but to let her make the choice.

I am curious about your client's under-developed breasts. You might ask when
she experienced menarche and if she had problems with menstrual cycles early
on. "Primary amenorrhea," where a young woman's menstrual cycles hardly get
off the ground, is a cause of underdeveloped breast tissue, though not
markedly asymmetric breast tissue. Any other relevant health/repro history?

~Lisa Marasco MA IBCLC

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

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