>I have nothing to add about stringy milk but will second what 
>Gonneke wrote - sounds like inflammatory process to me.
>
>Like Gonneke I am far behind on LN posts, but wanted to add a 
>comment about Yasmeen's post on the slow gaining baby.  I'd want to 
>look more closely at the baby, at a feed, and like Heather I would 
>want to be sure that the breastfeeding really was on the baby's 
>terms.  Heather wrote that the total gain from lowest weight after 
>birth was 640 g, but I can't get the total weight gain to be more 
>than about 350 g.


Yes - my maths were wrong, there :)

It would not change much for me, though, in terms of investigating 
what might be going on. Before doing anything else (in fact, as a 
volunteer and not an HCP, I wouldn't be 'doing' anything), I would 
still ask some very careful and thorough questions about what the 
baby was actually *doing* in terms of 'demand feeding'.  The most 
likely reason for any very slow weight gain (and this is very slow 
weight gain) is that the baby is not getting frequent enough access 
to the breast - in my experience this is *far* more common than the 
baby not latched on optimally, or some sort of pathological 
under-production.  I do think it is important to observe a mother 
feeding, too.

Not frequent enough access includes limiting breasts, limiting time 
at the breast, limiting frequency, adding formula - mothers can often 
do one or more of these and still think they are feeding on demand 
(an expression I really dislike, anyway!).

In the UK,  there is a very common idea among mothers and the HCPs 
who are advising them, that the baby should only ever have one breast 
per session. The baby is put back on the same breast repeatedly, and 
there is no breast switching. Now, given that nature is usually 
bountiful, many mothers still make, and babies still take, sufficient 
volume of breastmilk, for this not to be an issue (at least at 
first.....)  I have seen great results in improved weight gain simply 
by asking a mother about this, and when she says 'but the 
midwife/HV/this book I am reading says the baby must only have one 
breast because otherwise he won't get the hindmilk ' 
(aaaaaaargghhhhhhhh......) suggesting she switches breasts, at least 
once and possibly twice each time.

Heather Welford Neil
NCT bfc, tutor, UK
-- 
http://www.heatherwelford.co.uk

http://heatherwelford.posterous.com

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