Susan, I so agree with you and anyone who has heard Lisa Marasco's
lecture on insufficient milk supply would certainly agree that it is not
as simple as we used to think. If you have the chance to hear her, it is
even worth traveling to do so ( from one who came from Israel to hear
her). I am eagerly awaiting her book on the subject.
I remember once in my breastfeeding room, where there are usually as
many as 30 women all sitting around in the first few days after birth, I
was helping a mom who, like many others, was sure that she did not have
any milk. In fact, she had copious colostrum. Sitting next to her
within earshot was another mom artificially feeding her baby and telling
the mom I was helping that she also did not have enough milk and it is
ok because babies can grow well on artificial milk. Welllll, my hair
stood up, my claws came out, but luckily I controlled myself and started
to explain that if a woman is healthy and does not suffer from blah,
blah, blah or PCOS, she can produce enough milk for her baby. We got
the baby latched on and he started to audibly gulp the colostrum. I
noticed that the bottlefeeding mom had tears in her eyes. She started
to ask me about PCOS, and how this condition could affect milk supply.
It turns out that she tried to breastfeed her first 2 babies, did
everything in the book to increase her milk supply, including pumping
her guts out, taking every galactogogue in the book, using SNS's, etc,
and nothing helped. She has PCOS, but no one every told her that this
could be the problem, so until this very moment, she thought she was a
total failure that she did not make enough milk for her babies. I gave
her all the information on PCOS, including the possiblilty of taking
Metformin to help, and she said that years of sorrow had just been
lifted from her shoulders. She felt like a new person!!
Moral of the story……these moms need information, information,
information. And, we have to take a really thorough history before we
start trying to increase milk supplies.
I so agree with Susan's suggestions!! The next time you have a mom
with insufficient breast tissue, spongy breast tissue, lack of visible
veins, etc, which are definitely insufficient milk supply, ask her if
she is willing to meet with your colleagues so that they can learn to
identify these problems!!
Susan, it was wonderful to see you in NY, even for a few minutes. I
hope next time we will have more time!!
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
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