Dear all,

I checked Riordan, Lawrence and the Core Curriculum for the definition of primary and secondary lactation insufficiency.
Although I am pretty sure it is described in at least one of them, I cannot find it.
I did a little Google-search and didn't find conclusive descriptions there either.
I was under the impression that breast surgery is secondary (because iatrogenic, like bad management).
What I did find, though, seems to take different stands on the definition.
At one place, only management is considered secondary and hypoplasia and surgery and trauma are primary.
In another, hormonal and anatomical problems are considered primary and all the rest secondary.
What do you think?
And percentages...? I seem to remember that primary (really not able due to anatomy or hormonal state) is 2%.
For secondary without management issues (trauma, surgery, disease) maybe another 3%.
And for bad management...? Pfff... don't start me... ;o)

Anyone care to share her views with me or maybe even a strong definition in a reliable resource...? Thanks!

Bye,

Marianne Vanderveen IBCLC, Netherlands

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