Boy, does that 5% thing make LC's bristle!  I know we've discussed this
before--I wish Dr. Neifert were on here because I'd love to hear her thoughts on
the discussion.

I know that when LC's work in clinics or private practice it does give one a
skewed picture of things as KGA noted--you're only seeing the problems.  My
contacts with nursing mothers are more general, and I don't know that I see 5%,
but I sure don't see the <1% that Ina May reports.  I work at a hospital with
another LC.  We make rounds 6 days/week so see almost all the nursing mothers.
We do follow-up phone calls to all except multips who have had one or more
positive BF experiences and leave the hospital with no reported problems.  Even
excluding the mothers with hypoplastic breasts and breast surgery that appears
to explain the low milk supply, we regularly see women who do not have a full
milk supply--that cannot be explained by mismanagement.

In December I remember two moms we followed, both mothers very motivated to
nurse, normal appearing breasts, history negative for any of the usual causes.
We have good policies at our hospital--immediate opportunities to nurse, no
timing of feeds, pumping started within 12-24 hrs. if nursing does not appear
adequate.  If BF does appear adequate, we usually pick up any supply problems by
about day 3 to 5 and motivated mothers start pumping after nursings to rule out
any possibility of poor stimulation by the baby.  Both of these moms went full
tilt nursing, pumping, etc. for two weeks without any appreciable increase in
milk production.  Both produced approximately half the baby's requirements.  One
elected to stop pumping but continue supplementing at breast, the other weaned.
Only possible explanation for the one was her age (certainly not elderly but 36
y.o. prime), but no hx of infertility.  And yes, a higher proportion than would
be normal of the poor producers I see have had a hx of infertility (many have
been on clomid--but might it be the clomid or the condition requiring the
clomid???).

I don't know why most of us zealots get so up in arms when we discuss this
subject.  Why *would* we expect that only a minute proportion of mothers in this
country couldn't produce a full milk supply?  We've messed with mother nature
for so long--most of our mothers didn't nurse for any length of time, who knows
what drugs may have been given to our mothers when they were pregnant with us,
we feed our meat-producing animals all kinds of hormones and drugs, we spray our
food with pesticides, and mess with pregnancy and birth!  Isn't it possible that
some of these factors might affect our ability to lactate?

Becky Krumwiede, RN, IBCLC
[log in to unmask]
[log in to unmask]