In a message dated 4/30/03 3:47:46 PM Eastern Daylight Time,
[log in to unmask] writes:

> Here is an update on the twins I posted about a week or so ago. To recap,
> they were born 36.4 wks. by C-section. Weights boy 5lb. 5oz. and girl 6lb.
> 3oz. Mother had breast reduction surgery 5 years ago. This Mom is
> frustrated
> because at present she is only producing half of what the babies need in
> breastmilk. She is supplementing with formula for the other half. She wants
> to meet all the babies needs at the breast.

I am assuming that the mother is certain that babies or pump are effectively
removing milk more than 8x/24 hours per baby.  Obviously the breast reduction
surgery is a potential factor in production for this woman. Beyond that I can
say I've run into several MOT/MOM that have had initial production issues of
varying duration --  in spite of apparent effective BF/pumping were producing
volumes less than that expected for even a singleton infant. I can find no
consistent variable re: fertility, previous BF experience (several had it of
long-term duration), preterm birth, etc. that seems to impact. Galactogogue
use had varying effects -- from no real effect to fairly helpful Several
alternated galactogogues -- as one (or one combo) seemed to have a diminished
effect, the mother switched to a different one or combo. I can say several
experienced rather sudden increases in production at about 9 to 15 weeks
(varied) as per Barbara Wilson Clay's "priming the pump" analogy. I have met
several MOT/MOM, including some LLLL who had BF previous singleton(s), who
simply were not able to produce fully for more than one baby, although their
total volumes usually would have equalled more than for one single.

On the EXTREMELY bright side, this woman appears to be producing enough for
at least one infant, so that her twins are receiving her milk for half of
their nutrition. Per Scariati et al, this still means they are getting a good
"dose" of her milk -- far better than getting none of her milk!

A MOT/MOM does what she can do. This MOT is doing that (or appears to be). If
she keeps "plugging" away, she may be happily surprised with increased volume
eventually. If she is not, she has the reward of knowing she did her best and
her babies benefit from whatever she is able to produce.

If a MOT/MOM ever wants/needs to talk to someone who has "been there, done
that" with twins or who has worked with a large number of MOT/MOM, I am
always happy to talk to these mothers or the LCs helping on the phone, via
email, etc.

Karen

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