I just read the post on Tubular Breast.  Is it now called a disease? I had
not heard that but am not keeping as current as I once did. 

I read the post with great interest, I had a similar experience about 5
years ago.   Same breast description and very little  breast changes during
pregnancy.  The obvious difference was very early intervention.  I think
most of the time we reach these moms too late.  The woman I worked with was
seen right after birth, gave maximum skin to skin contact (without a diaper
part of the time).  Infant seemed to be nursing well but became fussy by end
of day 2.  There was no milk surge by day 3 and diaper output fell.  Only
drops of milk could be hand expressed.  Supplementation was started by SNS.
  Fennugreek was started.  (dose was high but don't remember amount, started
low and went up till mom smelled like maple syrup.)   Infant was put to
breast 8-12 times a day, most of the time with SNS.  Mom pumped post nursing
6 or more times a day, infant had few if any bottles.  By about day 10, mom
was pumping ~ .5 oz.  Infant lost some skill at breast and started hurting a
little even with SNS.  Mom continued almost continuous SSC, SNS nursing  and
pumping.   Sleeping was done in very small increments by the whole
household.  Gradually milk supply came up and on day 30, during co-bathing,
infant started nursing 'right' according to mom.  She needed only occasional
supplementation after that.  She never went more than 2 hours between feeds
until solids were started at 6 months.  She exclusively breastfed for those
5 months.  Infant was a very picky eater and had only small amounts of food
for first year.  There was never a milk surge and little feelings of
fullness.   Infant growth was great. 
Second baby came after 2.5 years, while first was still nursing.  Newborn
nursed well from hour 4 (c-section) and mom had full milk surge with very
abundant milk supply for the 2.5 years she nursed that child.  First child
finally weaned at 4 +.  

This involved a commitment that was probably unique.  However, I believe
that the extremely difficult is not impossible, even with these breasts that
look so hopeless.  (can't think of a better word, sorry)

After this experience I was very careful to be sure that moms I saw with
this type breast went home counting every diaper.  I fear that sometimes I
scared them, but better that than a dehydrated baby.  I also was able to
point out that early intervention is crucial.  I was hospital based and had
that luxury.  Private consultants have to just pick up the pieces and I fear
outcome is very compromised.  

Sorry for the long post, I may have left out some things, but this is my
best memory of the situation.  

One other interesting aspect.  After weaning, mom's breasts look exactly as
they did before giving birth.   

Carolyn Heinz, BS, IBCLC, retired

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