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Subject:
From:
Lisa Marasco IBCLC <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 17 Sep 2003 14:19:51 -0700
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Jennifer,
If I read your post correctly, at 96 hours+ mother's milk does not seem
to have come in. Baby's behavior and weight loss sound very consistent
with lack of available milk. Does this mom have otherwise
normal-appearing breast tissue? Did she experience pregnancy growth at
all? Do you see significant veining? What color is the milk expressed
from her breasts now, and how do they palpate to you?

It sounds like you could be dealing with either delayed lactogenesis or
a primary failure. Has she been screened for possible retained placental
products? Any signs of testosterone excess?

Your question was regarding the use of galactogogues. In either delayed
lact or primary failure, I think that galactogogues are worth a try, but
it is important to screen thoroughly for stuff like placental fragments
as galactogogues are not going to compensate for such confounding
factors. And yes, if the milk has not come in well, double pumping is
most likely necessary. While some babies are willing to suck forever,
most give up with the lack of reward and don't provide enough
stimulation to help bring milk in. A supplementer at breast is certainly
an option, though in my experience very few mothers make it more than a
day or two with them.

Lisa Marasco

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