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Subject:
From:
"Kermaline J. Cotterman" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 8 May 2001 23:10:08 -0400
Content-Type:
text/plain
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Cheryl,

I only know what I read about galactagogue herbs and medications. I have
never spoken, to my knowledge, to anyone who tried them.

Most moms we see at WIC who are maintaining their supply easily while
pumping at work have to pump 3 times in their 9 hour day (counting one
hour for lunch, and even more time for transportation to and from), which
would be approximately q. 3 h.

Even though she might not get as much at each pumping, I am really
impressed with how well it works when moms internalize our message that
both the thorough removal and the INCREASED FREQUENCY OF THOROUGH REMOVAL
(emphasis, not shouting) serve to stimulate the breast to produce more.
Milk removal really does seem to drive milk production.

Also, does she understand the concept of always taking a minute or so in
advance of pumping to do conditioned relaxation and hand trigger a MER,
and then wait for 2-3 minutes for it to react? This tip has helped
mothers get larger yields, as the MER is the most powerful force in milk
removal. Or at least veterinary literature says so.

Also, is the size of her flange appropriate for the particular placement
and distribution of her milk reservoirs? If she has deep reservoirs, no
matter what the size of her nipple, a larger flange might definitely pull
the areola further into it so that the breast will compress the sinuses
more effectively against the internal ring of the flange.

At 12 weeks, I don't think prolactin levels would tell you much, since
the mechanism of milk secretion switches to autocrine control, if I am
remembering correctly, at about 6 weeks or so, and prolactin levels
eventually begin to go lower normally.

That's why the thoroughness and the frequency of the milk removal is so
crucial. If I am understanding the process correctly, leaving the milk
undisturbed against the alveolar membrane for four hours is starting to
temporarily distort the arrangement of the organelles inside the cell so
they can't work together as well, and send more and more chemical signals
to the alveoli to slow the production, and to start reabsorbing what's in
process of being made inside the cell. That's all from memory, and I'm
sure there are others who could explain it better.

< Now she can feel a plugged duct on right side.
Confounding all this is she has a supernumery nipple vs montgomery gland
vs
nipple pore directly under right aerola which is painful.  No leakage
from
this site. >

Too hard to hazard an accurate guess without actually examining this
breast, IMO. I'm not really certain whether US would show anything that
could be diagnosable by a radiologist who might not be familiar with
lactating breasts, versus non-lactating.

Does certainly sound like some plugged ducts, pre-mastitis symptoms, and
soon to be followed by redness, fever, chills, etc. if not relieved. The
depo given at 12 weeks, would certainly seem to be an improvement over
getting it in the hospital!

Have you yourself inspected this unusual arrangement of tissue on the
right side? Did you use a magnifying glass? Palpate it? I would think a
little closer inspection would give you a better idea of what it really
is.

Keep us posted.

Jean
*************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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