Jaye,
I have read all of the posts about your client whose milk seems to
have disappeared. You seem to be in a bit of a bind, as the family
does not seem to be willing to trust the baby. I wonder if the family
has leapt to the conclusion that nothing should change at four months
and does not understand normal infant behavior (becoming more social,
often relegating feeding to nighttime and nap-time) and that babies,
like anyone, have no desire to have food shoved down their throats
and will resist in every way possible. Or, perhaps there is a family
history of early oversupply that results in down-regulation at this
stage of the game. Since, from my observation, such patterns do seem
to have a hormonal component, I would look there (in the history,
especially-ask about early feeding behavior.) I would also look at
the possibility that., as someone else suggested, down-regulation has
some other impetus, such as inefficient feeding due to structural
problems (you mention a high palate). I would do a full nutritional
evaluation, as well as early feeding experiences (both babies) and
outstanding family experiences that might be similar. Also consider
that babies will resist feeding when exposed to allergens or having
an oral thrush infection.
As to hypothyroidism--factors are most often nutritional, especially
iodine deficiency. I would explore those areas to give her info to
take back to her doctor, if they seem to be implicated. Many cases of
hypothyroidism fully resolve with iodine supplementation--considering
that the breast is one of the receptor areas in the body for iodine,
I think it is an imoortant factor in supply problems.
Jennifer Tow
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