Dear Margie,

Although little or no growth during pregnancy can be a red flag for production problems, many moms have presented this pattern and still produced plenty of milk for their babies.  Some moms have a lot of development just before or just after birth.  And I have known moms that were what you might call "flat as a pancake" who still produced just fine. Small breast size may indicate a small storage capacity (totally different from a small supply) which may mean that her baby will be nursing more frequently than the baby of a mom with a larger capacity for milk storage.   I would encourage her to maintain the outlook that everything is normal.  However, this is a mom that I would be sure to follow closely postpartum to make sure that everything is indeed OK.

There are other factors you should consider. The shape of the breasts can be as important as the size.  How do they look? Are they asymetrical, widely spaced, conical or tubular in shape - these anatomical variations are also sometimes linked to poor production.  Does she have a history of infertility, miscarriage or other gyno problems - more red flags.  How about breast surgery? It is important to view the big picture both when forecasting future problems or when dealing with a situation which has already developed.

The odds are that she will be fine.  Encourage her to nurse frequently which will maximize her supply and also decrease the chance of engorgement, which can sometimes happen more easily to a mom with small, firm breasts and little area for expansion.




Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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