Dawn wrote:

<I was working with a Mom today and noticed she had leaking from both of
her
areola's.  Has anyone noted this before?  Does it hamper the nursing
effort?>

It is not unusual to see milk exiting in small amounts from somewhere on
the areola. I cannot find the reference at the moment, but I read that
the Montgomery glands closest to the nipple are more like milk making
tissue (and in fact can secrete small amounts) and the Montgomery glands
closer to the outer area of the areola are more like sebaceous glands.

The small amounts produced do not seem to have any effect of the
production of the glandular tissue, in my experience.

<Her mother gave up nursing at 2 weeks due to not being able to keep up
with
the baby's demand.>

This viewpoint obviously effected her mother very deeply that it is still
being quoted to her daughter.
It would be important to affirm to her how this assessment must have made
her mother feel, but to point out that since a generation ago, there is
better, more evidence-based advice about breastfeeding availabe to help
today's moms.

The newer research that "milk removal drives supply" was at my first
hearing, "magic thinking" to me.

It was only after I heard talks and read enough research for me to
understand a little more about what happens at the cellular level that I,
as a lactation professional could accept it and begin to explain it in
simple terms to my clients.

Even then, many of them cannot get past interpreting baby's every
fussiness as evidence of some personal inadequacy of their breast. They
do not understand the normalcy of frequent feeding, nor of the pattern
described as cluster feeding.

Indeed, "insufficient milk" is often the assessment of mothers who are
attempting to describe their situation, relating it to the baby's fussing
so soon after feeding, and quieting down after "hungrily" wolfing down
some formula.

(Could a baby help himself, with a preformed nipple spraying so rapidly
toward his breathing passages something that is so slowly digestible?)

Many of these mothers, on further investigation, actually have an
oversupply, and babies are experiencing the effect of relative lactose
overload.

Informing mothers about the higher cream content when the most thorough
milk removal has taken place often helps them to let the baby decide if
and when to come off of the first breast before offering the second, and
then, perhaps offering the "third breast" (e.g. going back to the first
one again for the higher fat milk).

I hope someone can provide actual references for you, if that is what you
are seeking.

Jean
*****************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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