Hi community,

I attended a birth 5 nights ago as the doula for a G4 who also wanted extra breastfeeding support due to past "failures". Past "failures" include : baby#1 , jaundice did not subside, formula started and breastfeeding stopped. baby #2, breastfeeding, no weight gain, severe dehydration of baby and hospitalization of baby at week 4.  Baby #3, mother saw an LC, and attempted SNS with breastfeeding , with little success and weaned from breast. 

Baby # 4, 7 % below birth weight on day 5 ( today) no stool passed since meconium. 
Mom reports no breast changes during any pregnancy and has many of the hypoplastic breast characteristics ( tubular, asymmetry, wide spacing, no changes prenatal or PP, large areolas that appear fuller than breast).

I noticed the mom's breasts during the birth, and this thought ( hypoplasia) occurred to me. Today when I saw her for a day 5 visit, breasts look the same, baby is hungry, latches well, and has great rooting reflexes, but not stooling or gaining yet. Small drops can be hand expressed.

She is seeing a family practice doc who is supportive/knowledgeable of breastfeeding, but not to the extent of doing breast exams or feeding assessments.

I gave her the name of the closest lactation consultant which is  2 hours away, and in my experience, most women do not go 2 hours to the mainland for a consult, but I do give them the info and praises.

I am not comfortable, or should I say, I have no idea how to best approach this topic( of possible glandular tissue problems) with the mother. I am not sure it is even my place to suggest this is possibly the issue, because a) I am not a diagnostician and b) not an IBCLC ( yet) and c) if I hit her with that, then what? no one to follow up with? would her midwife be an appropriate voice for this ?

I would be happy to listen to suggestions on how to gently approach this topic, and plan to talk to her frequently in the next few days, although I am headed out to DC for the APHA annual meeting ( Friday).

~~~~~~~~~~~~~~~~~~~~~~~~~
Mirine R. Dye BS, CLE
Serving the Florida Keys

 

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