Dear Lactnet Friends,

Several of the last few posts have discussed the following:  "only in the
early hours and weeks will those receptor sites be "open" to receiving
prolactin.otherwise they fill up with progesterone."

OK, I always seem quite willing to share with you all my ignorance.  I have
to admit, that thru all the years and all the conferences and all the books
I've read, this is the first I have heard of this.  (grimace) I do take
comfort in knowing that some others out there will sigh with relief that
they werent the only ones hearing this for the first time. :-)  I have heard
that "research states that what the moms supply is at 2 weeks is an
indication of how her supply will look at 6 weeks and beyond", it seems I
just missed out on the part of the progesterone filling and clogging these
prolactin receptor sites.  

I see quite a few woman with supply issues.  Many are unexplained.  They may
have no apparant red flags.  (no problems getting pregnant, no breast
surgery, no thyroid problem, no diabetes, no cone shaped breasts, no 3"
space between breasts...)  The most common red flag I will notice is little
to no breast tissue growth during pregnancy, and little to no engorgement.
SO - with above theory mentioned, I should have all these moms with little
to no growth pumping 8xday. (as the baby that is not receiving much milk at
the breast is more likely to be the "sleepy" baby at the breast, and not do
much in the way of "sufficient" stimulation)  Granite, some will not improve
as they may have insufficient glandular tissue within the breast. 

Also, does this eliminate our concern during engorgement of "creating a
monster" by pumping too much?  I have always instructed moms to pump for
"relief", and by just "softening" the breast, they won't mess up the normal
supply/demand thing.  But if sufficient removal of milk is so important to
supply in the first few weeks....then we could suggest they pump till flow
stops? 

I am guessing this is more indepth than I am trying to make it. If mom is
engorged, she should watch for signs of milk removal, (ie. sufficient
wet/soiled diapers, softening of breasts, audible swallows, content baby)
and if having above signs, she should probably pump for comfort.  If mom
isnt getting above signs, she should pump frequently and often till flow
stops. ?

I was just thinking how nice it would be to have everyone offer breast first
and follow it with pumping till flow stops times 2 weeks.  I wonder if more
moms would have a great supply?

Will someone point me to the correct text to further my education about
this!

Embarrassingly,

Linda Hill RN, IBCLC
Austin, Tx

 

 


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