Continuing on this nearly defunct thread, this is an update following a
meeting with a mother who struggled with nearly non-existent milk production
for several weeks before things started to happen.  

The background: edema prenatally, exacerbated by factors in labor and
afterwards, and severe engorgement postpartum with long delay in
lactogenesis II.  

In this case there was very little milk in evidence until about one month
postpartum.  Small amounts expressed, baby mostly fed on ABM and not seeing
any reason to latch on to breast.  Then things started to improve, and when
I saw her last, the baby was all but exclusively breastfed.  When baby has
slept for a long time, she still gets too frantic to latch, and on the rare
occasions when there is no expressed milk ready to settle her enough to
latch, she gets ABM.

So, what did I say now?  I told her that just weeks before, I never would
have hazarded such a prediction and that I might not have believed it
possible.  She in turn told me that it had been a relief to her when I said
'I don't know whether you will be able to breastfeed exclusively, I can't
say.'  Because this took the pressure off her, it made it all right to
simply breastfeed without thinking about the amount of milk the baby might
be getting from a package from the store.  Her health visitor was
communicating the same message, hooray for consistency.  And she and the
baby just kept on, and all of a sudden they are not breastfeeding as a hobby
alone, they are just plain breastfeeding.  

Norwegian mass media love to accuse the health services of putting pressure
on mothers to breastfeed, which is not only inaccurate, it reveals complete
ignorance of the history of breastfeeding in this country.  I'm sure there
are units without the resources I have, in which mothers who encounter
problems are exhorted not to give up, but are not given individualized help
to deal with their difficulties, and in such circumstances mothers do say
they feel pressure to breastfeed.  But this woman's words were music in my
ears.  She said she never needed any pressure to breastfeed nor had she
experienced any, even when I had told her outright to keep on for at least
one more week.  That was when her production had quadrupled in just a few
days and I could see that things were starting to resolve, where all she
could see was that she had spent six weeks getting to the point where she
was producing about half what the baby required, and it had taken an
enormous effort and she had no idea whether she was looking at another six
weeks of the same kind of effort before it would bear fruit.  Rather than
pressured, she said she felt accepted and supported as she was followed
throughout a rather tortuous first couple of months, before the sun at last
came out and began to shine on her and her baby.

Rachel Myr
Kristiansand, Norway

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