I just finished a sad conversation with a client whose milk supply is
decreasing rather than increasing at 7 weeks pp, despite our best efforts.  She had
had a milk supply problem with the first baby and I saw her at 12 days pp with
the second baby.  Her breasts were somehwat hypoplastic.  At breast, infant
took in 14 cc, (test weights) and she pumped 15 cc with a Lactina.  HX revealed
no fertility problems, no surgery, etc. She rented a pump and slowly her
supply climbed, she began domperidone at 4 weeks pp and she got up to almost 2 1/2
oz per feeding and then her supply began to drop, despite no changes in her
pattern of feeding/pumping.  She thinks she is down to about an ounce per
feeding now. Infant enjoys nursing and she will d/c pumping and the domper. but
will continue to offer breast.  I have suggested thyroid function and perhaps
endrocrine work-up.
   She was in the grocery store last week buying more formula and the store
clerk who was a stranger said to her," oh I see you decided not to breastfeed."
 Naturally she was taken aback and said no, she was also breastfeeding.  But
she felt attacked and depressed since she had truly done everything she could
to increase her supply.  She then told me how troubled she is because she
feels there is so much discussion about IQ and breastmilk and feels maybe it isn't
true.  she wants her infant to have her milk but it didn't work -  I gently
explained that the information about IQ is based on research but that the
important thing was that she did her best and that her baby benefited for all the
milk he had gotten and that weaning time comes for all of us, just not always
at the time we had hoped.  So this was a real up close and personal example of
how important it is for us to be sensitive to people and what they do.  We
don't always know the whole story behind the choices they make.  I hope I have
helped her to be ok about her situation.  There truly are women whose bodies
don't function properly (just like some women can't get pregnant).  Judy
Eastburn, BS,IBCLC  Private Practice,  Dallas, TX

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