someone (sorry!) wrote about their borderline gaining, hungry appearing baby/
insufficient glandular tissue Mom.
I would agree that if the baby is hungry (seems Clear!), this weight gain
pattern reveals baby isn't getting enough.   Isn't this why we are always
repeating "wt. gain is just one of the variables"!   Some babies can appear happy and
round with this pattern of gain.   On the other hand,   I consulted recently
with a 2.5 week old who had gained 4oz in 2 weeks. Pediatricin was not overly
concerned (did not start supps), just referred to me.   I fought back a gasp
when I saw this baby-VERY cachectic looking, literally inhaling his fists.   In
this case, Mom had good supply but baby was very inefficent feeder.
In terms of insufficient glandular tissue, I have a question.
 I consulted with a Mom a couple of years ago (posted on her as well) with
assymetrical but bilateral insufficiency. She called me again recently having
had her second baby to talk about the differences in the nursing experiences.
This time, she managed the nursing quite differently from the beginning -
focusing on optimizing the efficiency of the feeding and pumping post feed.   She
was able to report more milk this time BUT was still supplementing.
What was of interest to me was her pattern of supplementation. She had come
to the conclusion that her breasts, despite optimization as above, had a
threshhold of milk that they would produce ie. enough for 4   "good" feedings /day.
Although very different from the frequent, complete emptying tactic she had
employed at great length with the first and again for a while with the second,
she felt that she could maintain her supply at the *same volume* with the 4
unsupplemented feeds.   She much prefered having these times where she could feel
secure in the amt of milk she had accrued and relax and enjoy the experience
vs. "fighting" with her body to make more.   My question is does this make
sense physiologically?   Can we feel comfortable offering this as an option to
the Mom who has tried all to increase but now   wants to maintain production?
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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