>>This person may pump 1/2 to 1 ounce maximum even if the baby has not fed
for a couple of hours<<

Judi, I've noticed something different. Some of my moms who max out at maybe
1 or 1.5 oz a pumping session may report that the most they ever got was 3oz
(double or more the usual), ocurring when they went all night or otherwise
missed multiple feedings. This suggests that they have the capacity to hold
the milk, but that the *rate* of milk synthesis is not responsive to
stimulation.

>>The other big thing I have noted anecdotally is that young mothers (teens
to twenty-five or so) usually have milk come in no matter how their breasts
look and in spite of no changes in pregnancy.<<

I've just finished working with a 15 yr old who had dog-eared breasts--
definite hypoplasia, and very little milk. This client's mother was also
lactating, and she had very normal, well-developed breasts with a good
supply.    I've had another teen as well, and some early 20's moms, who also
did not make enough milk; breasts usually soft, sometimes under developed..
BUT......

You ask a really good question about compensatory breast development. I have
discussed this some with Dr. Randall Craig. Puberty is sort of a "window"
when hormones stimulate the development of secondary sex characteristics.
When does the window close? Does it close all the way? Can it be re-opened?
He believes that the cancer gene cell research may eventually find the
answers to those questions. I also believe that late teens and early 20s may
respond to intervention IF we know how to intervene.

This is one of the reasons I am increasingly interested in early
identification of hormonal problems such as polycystic ovary syndrome. A
good friend of mine confided to me in horror that she had recently seen her
college-age daughter's breasts for the first time in a long time, and that
they seemed "deformed" to her. Said daughter also has some other symptoms
that suggest hormonal problems. I'd sure like to catch these young women and
have them treated early in the hopes of allowing for more normal development
in the critical windows. I also do wonder if BCPs, often prescribed to
regulate irregular cycles, might be a positive intervention by helping with
progesterone, which is very low if there is no ovulation.

Lots of good questions, not enough research and answers yet.

Lisa Marasco MA IBCLC

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