At 12:02 AM 19/04/02 -0400, Donna wrote:
>1. How does the mum know how much supplement to give if she is trying to
>reduce the supplement and increase her supply?

There's all sorts of ways to do it Donna.  What I recommend is starting the
day without the SNS/supplement.  That's usually when the breasts are
fullest and the baby likely to get the most milk.  He'll demand again when
he is next hungry and she could use the SNS then ... then gradually give
more and more feeds without the SNS beginning it later and later in the day.

>2. Do herbs and medications work for a mum with a breast reduction?

Yes - in my experience they have worked very well.

>  Does
>the supply increase but there may not be enough ducts to empty out of?
>How does this work?

No.  After lactogenesis II (endocrine control) is done, then milk synthesis
moves into autocrine control.  It's only the alveoli from which milk is
being removed that will continue to make more milk.  The alveoli that have
no connection to the outside will involute.  The better the alveoli which
do have an 'exit' are drained the quicker will be the milk synthesis in
them.  That's why it may work better to start the day without the
supplement.  If the baby is filling up on breastmilk and supplement and
leaving some breastmilk still in the breast, then milk synthesis will be
slower than if the baby had taken as much as possible from the breast first.

I don't know what ability she has to produce milk at this stage, but it may
be possible to suggest to her that she forgets all about supplements until,
say, after lunch.  Every time the baby wants to feed before then she's just
like any other breastfeeding mother and it's just breast - even if it is
every hour.  Then the needed supplements can be given with each breastfeed
after lunch till bedtime.  That will give her some time to feel like all
the other breastfeeding mums.

I'd also highly recommend that she join the breastfeeding after reduction
internet support group.  The address is www.bfar.org

Congratulations on having such a large and vibrant group.  You must be
meeting the needs of your community really well.. Well done.

Denise

*************************************************
Denise Fisher
BreastEd Online Lactation Studies
http://www.health-e-learning.com

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