Dr. Woolridge gave a fascinating session on this topic at the 95 ILCA Conf,
Session 205, The Analysis, Classification & Etiology of Diagnosed Low Milk
Output.

I ought to listen to the tape of this session before trying to pull some info
from it, it was one of those that is difficult to absorb at one sitting, I
can't always interpret my notes - when I'm writing fast!

But here's some of what I understood.  He listed the stages of lactation as
1) Priming 2)Initiation 3) Calibration 4) Maintenance 5) Decline 6)
Involution.

  He said that 85% of apparent breastmilk insufficiency is reversable, with
what we all do best, optimizing bf management, technological support of
physical aspects of BF, & Support and encouragement.

He gave 3 classifications:
Iatragenic low supply: evidence of higher supply that has dropped.  This is
an acquired undersupply that irreversable - the breast re-calibrated at a low
level

Behavioral low output: induced by infant self-limiting intake at an
inappropriate low level,
may be reversable but difficult.

Patho-physiological low supply  (which he said was 2% or less of the
insufficient population he was reporting from)
Result of dysfunction related to postpartum event, i.e. Sheehan's syndrome
Retained placental product
Intrinsic organic problem - no growth of mammary tissue during puberty, etc.

He specifically talked about the period of time during the
initiation/calibration stages that required the necessary stimulus or there
would be a premature decline/involution.

I've heard other lecturers state it's crucial that the breast's get regular
stimulation that begin within the lst 24/48 hrs, or it may be difficult to
obtain an adequate supply.

He evidently had not published this info at that time, at least there were no
references of such.  Anyone know if he's published on this subject since?


Kathe Catone, IBCLC, LLLL ([log in to unmask])  - who will listen to the tape
and see what I missed.