Cheryl's point is well taken that in individuals, there may be wide ranges
of physiological differences.  She has had insulin resistence issues and had
no problem making milk.  Others have described similar ranges in lactation
performance with regard to the anemia issue.  And yet there are case reports
and research describing these as red flags for poor milk making capacity in
other individuals.  It's like tubular breasts or previous hx of breast
surgery.  You want to take in this information as part of a comprehensive
assessment, but it is only one piece of the puzzle. Some women with very
unusual looking breasts do fine.  I have had moms with free nipple graft
reduction mammaplasty make full milk supplies. I think of breastfeeding as
such a robust process that there has to be more than one thing going wrong
for it to falter badly.  But that said, there is such a lot of work that
hasn't yet been done in terms of understanding the physiology of lactation.
Insulin resistence is pretty interesting.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com
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