I work in affluent community hospital outside New York City.  We currently 
have our own affliated IVF clinic and are seeing many more of these 
mothers.  Whenever I see "IVF" listed on the kardex for a patient it 
immediately sends up a red flag to me.  Many of these women have 
underlying issues (such as pcos, advanced matenal age) that prevented them 
from getting pregnant without intervention.  Many of these same issues may 
rear their heads again once the baby is born and breastfeeding is 
initiated.  These moms also tend to have deliveries with more 
interventions -increased chance of augmentation and c-section, which 
have a direct inpact on lactation.  Lastly, these moms tend to have a 
mistrust 
of their body.  They simply don't trust, that it will "work" like it is 
supposed to.  After all they've been thru, who can blame them for feeling 
this way? They tend to require more time and effort, but we have seen many 
successes.  I think the issues are both physical and psychological...for 
many probably both.

Denise Bulpitt RN BSN IBCLC
    

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