I have to disagree somewhat with Holly and Pat this time. I do believe that
normal breastfeeding does not need to be medicalized, just like normal
thyroid needs no attention.

On the other hand, when there is a problem or dysfunction in any organ or
bodily process, this should be investigated and managed (treated). I feel
highly qualified (as I am sure both of you are as well) to comment on low
milk production or whatever you want to call it. I talk to tons of moms in
3 different jobs, and I work almost every day of the year. And I've been at
this for over 30 yrs. First, I do not hear the 4 hour mantra, and haven't
in a very long time. The moms I'm in contact with seem to have a realistic,
for the most part, expectation of baby feeding patterns.

Some moms say "yeah he's feeding alot and cluster feeding, but I just go
with it." These babies are settling down for the most part. Other moms say
"I am feeding him constantly, we are not getting any sleep and he cries all
the time." These moms know there is something wrong and there is. These
moms are exclusively breastfeeding, with very good prenatal and postnatal
support, and support of Ob and peds, and they rent symphony pumps, some use
SNS, and take galactagogues and all of that.

There are a lot of these moms out there, unfortunately. So I do think this
MODF (whatever name is best suited for it) is for real and not that
uncommon.

Some moms worry unnecessarily about their baby's intake and supplement
unnecessary, and thereby unintentionally create low milk production. Today
I had a mom who had a few mo old baby gained from 7 pounds or so to 15 lbs
now and says "I worry my baby will starve." She was not supplementing and
hopefully my reassurance helped.

More discussion always welcomed.

Laurie Wheeler RN MN IBCLC
New Orleans and Gulf Coast, USA

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