Thank you to all who posted privately and to the list about my client whose
milk (still) hasn't come in.  She sees her MD in two days for her routine
postpartum check up.  I have asked her to really push for an ultrasound to
rule out retained placental fragment.  I appreciate the posts asking if I
had explored emotional issues.  Yes, and making a home visit allowed me to
assess the physical and emotional environment.  House wasn't perfectly
clean, but was functioning well and wasn't chaotic.  There appears to be a
comfortable income.  The one older sibling is a little girl about 3, (baby
is also female) and Dad was home for two weeks after the birth.  He was
present during my consult, helping with the 3 yr. old.  He seemed
appropriately concerned, supportive, and very kind to the older child.  One
only gets a snap-shot of the lives of our clients during one visit, but I
have had numerous conversations with this mom and get no sense she is
overwhelmed, ill, or depressed.  She is baffled, appropriately concerned,
and sad there is no lactation.  She has a long list of questions to ask MD.
She is annoyed she has only been able to talk with nurse so far.  So I have
to say I am sticking to my instinct that this is about retained placental
fragment.  I have seen lots of really stressed moms lactate through deaths
of family members, etc. and of course the whole human race continues to live
inside the maelstrom of the human condition, during which lactation mostly
proceeds without incident.  So yes, stress is bad, but I think it would have
to be REAL bad for it to suppress lactation this totally.

I'll keep you all posted.
Barbara


Barbara Wilson-Clay BSEd., IBCLC
Private Practice, Austin Texas
Visit the "LactNews-On-Line" Web Page
http://www.jump.net/~bwc/lactnews.html