I want to echo Kate Hallberg here: 'I worry when people do allow their
limitations
to be *so* limiting as to prevent them from trying', and expand her
statement to include those who are helping mothers breastfeed - when we
allow a perceived limitation or even just an increased risk of a limitation
to prevent us from trusting a woman's ability to breastfeed before she has
even started, we are no better than anyone else who says 'breast is best
BUT...'

A recent encounter with a mother with PCOS, pregnant by IVF, brought it home
once again.  She had several hurdles to clear in addition to her PCOS -
forceps delivery after failed vacuum extraction the most prominent of these
- and when she returned for planned follow up for difficulties with BF,
mainly positioning and latch (oroboobular disproportion being the key words
here), her baby had gained 370 g (12 oz!!!) in one week, and the pillow on
which the baby was lying while she BF her in my office, needed wringing out
afterwards from the milk that leaked out of the other breast while baby was
suckling.
This is a more common scenario where I practice, than low supply, even in
mothers with PCOS.  If I were to be anxious on behalf of every woman with a
medical condition I would need drugs myself.  Far better to assume the best
and be prepared to deal swiftly with any real problems that do arise - and
at all costs don't alarm the mother.  In this case she had enough problems
with self-confidence after needing help to conceive; I would be the last
person to hint to her that there was a chance she would not produce enough
milk.  Plus, I would have looked d***ed silly if I'd done so too, in light
of how well it did go.
BTW, the one thing I did which she said helped her in dealing with the
challenges of her baby's first days, was to point out that the baby didn't
have anything to compare her with, so everything she did would set the
standard for How Things Are.  Good for women to remember when they don't
look exactly like the models in the book illustrations, or don't bathe or
change or feed babies as quickly and 'efficiently' as staff do.
Rachel Myr
(I'm a midwife, everyone knows we LOVE pain!)
Kristiansand, Norway

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