You are taking an awfully long time to answer me, now that I shot my mouth off. did I go too far?
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Subject: LACTNET Digest - 14 Sep 2003 (#2003-1232)
There are 3 messages totalling 170 lines in this issue.
Topics of the day:
1. lesbians and breastfeeding
2. dr. report/Kathy's suggestions
3. relactation
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Date: Sun, 14 Sep 2003 21:58:20 -0400
From: Fiona Dionne <[log in to unmask]>
Subject: lesbians and breastfeeding
> One issue that I think should be addressed is whether the non-bio mother should opt for
> the intensive medical protocol for inducing lactation, when
naturally produced breast milk
> is available. In one way, this may appear to be a good choice for
use of what has come to
> be know as "the protocol", since the likelihood of going through it
and then ending up with
> no baby is so much less than with a mom who is going through a
traditional adoption.
Good point...
> However, unless the bio mother is really unwilling to nurse and/or
pump her milk,
I would totally support the idea of a couple where the bio mom didn't
WANT to nurse, and the non-bio mom DID, I do think that would be
wonderful to have that kind of "back-up" in some sense. :-)
> protocol to be able to nurse with little or no supplementation,
what happens to the bio
> mom's milk supply?
Another good point...
> What I have suggested, in the cases I have been consulted on, is that priority be given
> to getting the bio mom's milk supply well established, and that, if
the non-bio mom
> nurses in the early weeks, it is for short periods, and primarily
for comfort.
I could have used someone who produced very little milk themself in
order to comfort my children, who disliked nursing to begin with when
my MER was very strong. ;-) I donated milk to a friend who had
limited supply and we both joked once that it would have been quite
neat to live close to another: I could feed them and she could soothe
them at the breast.
> I have known several cases where the non-bio mom has been the stay at
> home mom, and has done a great deal of the nursing. In this case,
the non-bio mom
> will usually start to produce some amount of her own milk, just
from the suckling
> stimulation, but still need to provide EBM at each feeding.
> to result in the baby getting somewhere around three fourths milk
from the bio mom and
> one fourth induced milk, which I think would be a very acceptable
situation.
Yes, I can see where this would be a good situation. A friend of mine
(a lawyer) says she doesn't think she could get more than 6 mos off of
maternity leave. When the time comes for children, I will try and
encourage her to pump, but if her husband were to stay at home and
feed bottled pumped milk, it wouldn't be much different. I think
personally I'd exchange the milk that is not "made for my baby" (in
the same way) against the possibility of nipple confusion with the
artificial nipples. In fact I know I would.
> In this case, as with others, an adoptive mother should always consider what is
> best for the baby, and be sure that she is driven primarily by
that, and not her own
> needs to produce milk. I don't know if that makes sense to those
who haven't had much
> experience with adoptive moms inducing lactation, but there are
times when a woman's
> personal need to see that her body is producing milk can become her
first priority,
I should ask my mother if she would have considered adoptive nursing
had the thought occurred to her, or had it been presented as an idea
(my younger sister is adopted). As it was, with a 10 mos. old who was
used to a bottle, the thought did not occur to her for one, and no one
presented the idea as an option either. But I can see how it could
become damaging to the relationship if the mom got so stuck on the
idea of nursing that everything else went down the drain. There is a
happy medium I guess, as you say.
Thanks for your thoughts on this...I was hoping you'd have something
to add to this. :-)
Fio
ressource person with Allaitement Québec
Mama to Sandrine, 3.5 yo and Nyssa, 10 mos, tandem nursing.
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------------------------------
Date: Sun, 14 Sep 2003 21:40:35 -0500
From: amyibclc <[log in to unmask]>
Subject: dr. report/Kathy's suggestions
Thank you, Kathy, and others for your helpful suggestions. Kathy, to answer your questions, yes, yes, yes! I do have clients sign with their consent for me to communicate with doctors but am going to quickly get on the task of adding a line for THEM to fill out with the doctor's name. Yes, I use a Baby Weigh scale, except that when I arrived for this consult, the baby was already nursing so I only got the weight after that feeding. At that point she had lost 7% but looked horrible. Yes, I also use individual care plans and go over it with the moms. I was dressed "business casual" at this visit, use good forms and a cell for business, have insurance, etc. Thank you for affirming my efforts!!
This conversation earlier touched on midwifery care. I have to add that I also think the homebirth babies are well-cared for by midwives in my area. I tried to have my second child at home and had planned to have #3 at home but recently lost that one. My issue here was not midwives in general, just this one. The other client to whom she recently gave the suppositories for the "constipated" baby e-mailed me today and expressed appreciation for my explanations to her of how close her baby was to the "danger zone," what their options were, and how much time they might have to explore them. She also said she knows now her baby was not constipated but needed additional nutrition. I'm hoping this second client, about whom I posted, will come to a similar conclusion. If not, that's okay, because now I know in my gut I did what was right. Thank you all for affirming that.
Gratefully,
Amy
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------------------------------
Date: Sun, 14 Sep 2003 23:23:47 EDT
From: [log in to unmask]
Subject: relactation
Given the case history, I'm not sure the "re" in "re-lactation" applies. It
sounds like this mother has had low supply from the get-go, and most likely
it is the insulin resistance that is the culprit here. Her health history is
full of it: no breast changes during pregnancy, no noticeable "engorgement,"
postpartum--in fact, she felt like her milk "never came in," previous history
with first child of low supply, overweight, fertility problems, in fact, she
had diagnosed PCOS. A lot can be reported via email/mail, but to determine
if this is good old-fashioned acquired low supply or pathological low supply,
one would have to see her breasts in the crucial period of time (e.g. day 4, 5,
or 6) and actually take a good look at what is going on. My educated guess
would be that the supply is innately low, but I haven't seen her. Sounds
like a good Metformin candidate, but she may have missed the window, since she is
on day 32 now (or thereabouts).
Switch-nursing for these moms tends to be the best thing, as the babies stop
swallowing when the flow slows, so the whole foremilk/hindmilk thing is moot;
the baby never *gets* the hindmilk if there is no flow.
Heather Kelly, MA, IBCLC
NYC, NY
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End of LACTNET Digest - 14 Sep 2003 (#2003-1232)
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