>I am assisting a 36 yo primip who had breast reduction surgery 8 years ago.
>She is producing milk, but each breast has several small lumpy areas behind
>the areolae.  The breast is generally soft.  She is able to express 1 to 1/2
>ounces when pumping.

Sounds like there may be areas of the breast that do not have outlets to
the nipple. These will naturally involute after a while.

>
>Her baby is 12 days old and not gaining well.  She nurses every 2 hours, and
>feedings last 30-40 minutes.  She has no nipple soreness and the baby's latch
>is ok.  The baby often seems unsatisfied after the feed.  Mother understands
>the need to supplement but wants to do everything possible to maximize her
>milk supply and minimize ABM feeds.

Perhaps she could consider using a SNS type system.

>
>What would the consequences be of 'traditional' techniques to increase milk
>production?  If she pumps more frequently, would that lead to more lumps and
>discomfort?

I wouldn't think so. My thoughts are that there are no outlets for the
lumpy bits, so it should not affect them. If more demand is put on the
existing breast tissue that *does* have an outlet (ie intact ductal
system), this will cause an increase in milk-making tissue feeding this
system. Peter Hartmann has said that the breast tissue with a continuing
high demand on it, *is* able to cause the cells to divide and grow more
tissue, ie postnatally. I guess this is similar to an induced lactation
situation.

 Would fenugreek be worth trying?

Can't hurt, and might help stimulate the existing tissue to grow faster.


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Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask]
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