Hello!

I really appreciate all of the discussion and responses I've read to my post
last night about hypoplasia.  I have a few points to chime in on.

I also dislike any medical term that uses negative language...but I'm not
sure "lower storage capacity" is necessarily the best alternate term for
hypoplasia because, as I understand it (I could be wrong, I'm still a
neophyte!) hypoplasia refers more to the milk "factory" tissue not being all
there, not the storage.  My friend told me yesterday that when she wakes up
in the morning after a few hours of not nursing, she has one patch of her
breast that is "hard" similar to what I remember of my entire breast feeling
like when full in the morning.  The rest of her breast, which could very
well "store" milk, feels soft and loose.  

Please correct me if I'm wrong on this but my understanding of hypoplasia is
that, for whatever reasons, the breast tissue did not develop completely
during times of hormonal influence like puberty, pregnancy, and immediately
postpartum, and there is therefore not enough *milk-making tissue* present.

That said, I am very interested in what Heather from NYC has raised in
discussion about how demoralizing it must feel for some mothers who never
bring in a full supply despite all the best intentions and actions, and how
we have, as a society, given the impression that breast or bottle is a black
and white issue.  In this situation or any other (I'm thinking mothers who
need to separate from their young infants), I stress two major points:
first, indeed, any breastmilk is better than no breastmilk and each mother
needs the information and tools to make an informed decision and take the
course of action that is going to work for her and her family.  Second,
breastfeeding is not only about the milk.  While those mothers who struggle
to bring in a full supply may feel frustrated with breastfeeding at the
breast (like those mothers whose babies end up primarily fed with something
other than their own milk for whatever reason), I have found that many of
these mothers value the closeness, physical contact, and special connection
they get from "feeding" at the breast even more.  I am always certain to let
mothers know that they don't have to stop breastfeeding because they have to
supplement, because the baby (and mother) is getting so much more from
nursing than just the milk.  I think someone here already mentioned how
freeing it can be for a mother who has been a slave to supplementing to
reach the 12-month mark and continue breastfeeding at the breast without
worrying about supplementing ever again (with that child) -- even if that
child is getting a minute amount of milk, it still contains amazing things
we don't even know about, and the "tool" of mothering at the breast can be a
terrific one whether a mother is supplying a lot of calories or not.

There is a conference on Long Island in November (2nd?) during which a
speaker (Nancy Mohrbacher?) will present about helping mothers who
exculsively pump and EBM feed ( I think someone mentioned this might be a
good conference topic.)  I can't go to the conference, but I'd be interested
in learning about whether the immune properties of breastmilk are as strong
for exclusively pumping dyads, because I am under the impression that a lot
of the germ-exposure/immunity production actually happens at the breast --
baby gives mother the germ, mother makes the antibody, passes it back to
baby...does this work if there is no feeding at the breast?  My guess is
that if it does, it would be significantly reduced.

Of course, I agree wholeheartedly that, bar none, expressed breastmilk is
better than ABM when considering the health of the baby...I just wanted to
raise the other points of discussion as well.

--Diana Cassar-Uhl

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