To Becky,

Re: >breasts with no milk or very minimal milk.  They are small and especially
unusual in the shape
>of the areola--more cone-shaped and distinct rather than looking like a
>pigmented part of the breast.  From the side the breasts look more like > than
).

I agree with you that "these breasts" are immediately recognisable and
will never yield a full milk volume.  I call them pre-pubescent breasts
(to myself, not the Moms) because they look like an 11 year old girl's
breasts that have just started developing.

I see 3 or 4 clients a year.  I recommend pumping post-feeds in the 1st 3
weeks (when prolactin receptors are most sensitive) to superstimulate breast
tissue ie. tell the body there are triplets
out here, and using a Lact-Aid Nursing Trainer.  One of my clients
persisted with the pumping for  5 months and managed to produce 40% of
baby's needs.  M.D. diagnosed "mammary hypoplasia" but did not mention
etiology. Her first baby had been admitted to hosp @ 5 days with
dehydration and she'd started formula.  2nd time she was determined to do
everything right - hired a L&D coach, phoned me when baby was born and
asked me to come right away.  I saw her at 6 hours post-partum and knew
right away
there were going to be "big problems".  She left hosp. @ 12 hours, picking
up a pump on the way home.  By 48 hours we had to start formula
supplementation  via Lact-Aid because baby was just not getting enough.

What really bothers me is that none of the health professionals she saw
with 1st baby, or during pregnancy, labour, and delivery x 2 ever told her
there was an anatomical problem.  This Mom thought she'd wrecked BFing the
1st time because of mismanagement.  MD only wrote Dx. in letter that she
requested for health insurance company after she'd been through everything.

Another Mom whom I saw on day 6 on physician referral because baby had
already dropped 1 lb. to 5 -4 had been seen by a LLL Leader 2 days
previously.  After she 'd heard from the Mom what I had recommended - (this
Mom only pumped 2 weeks, got very little but continued with Lact-Aid for 4
months) - the Leader phoned me and asked was it really true that some Moms
can't produce enough milk!  Unfortunately, YES!


--
******Joan M. Fisher, RN, BN, MEd, IBCLC******
***********Ottawa, Ontario, Canada************
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