I looked back over this last month. This is not scientific because our
bf rate is only about 40-50%, so I do not know what the situation would
be for the mothers who did not choose to initiate bf. But I had 3
mothers out of 43 who wished to bf (7 percent) whom I had identified in
my notes to myself to have breast hypoplasia, usually described by me in
various ways such as very wide-spaced breasts, tubular, conical, marked
breast assymetry, flaccid, increased striae. In all cases, the milk
production was insufficient.
The first mother was bf and came in for followup on day 4. She had just
recently begun supplementing because the baby had no poops and very
little urine output. (Many moms with these findings tell me the baby did
not poo since hospital discharge). The usual bf techniques had been
tried, i.e. feed very very often.
The second mother was excl bf and on day 4 at the clinic visit the baby
had 14 % wt loss and decreased urine and stool output. Supplementation
and strategies to increase milk production were instituted. We followed
mother til day 9 and she continued to have low milk production, she
agreed to a plan she was happy with (declined lactation aid).
The 3rd mother was described in a prior post, that mother decided, in
consultation with me, to begin bottle feeding formula prior to 24 hrs,
while expressing to try to stimulate her milk production. Of course we
discuss galactagogues, appropriate pumps, etc. She also declined lact.
aid.
So I again have to wonder, should we begin supplementing these babies
early? Should we share our strong suspicions (however tactfully) that
the mother will experience a lower than usual milk production? Are the
babies suffering unnecessarily? (These moms tell me the baby cried all
nite and was very very gassy).
Laurie Wheeler RN MN IBCLC
Mississippi USA
-----------------------------------------
Smart Medicine. Inspired Care. And the awards to prove it.
Recognized as a Top 50 Healthcare Network.
To learn about other recognition and awards Baptist has earned,
visit:
http://www.bmhcc.org/aboutus/awards/index.asp
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