I beg to differ regarding all moms having fat in the milk who have had bariatric surgery!? I followed the one mom for over a year who did well the first month and then it became apparent things were struggling.? (after a definite failure to thrive by 4 months she would only give 1 formula bottle a day while she worked on her B12 absorption, and it worked) Baby had a strong perfect suck/latch, mom had an overly abundant supply!? She could pump more than plenty.? I did pre post weights, baby did phenomenal. It was NOT a supply issue.? It was a?fat issue.? It was NOT an emptying issue.? And was very very apparent when she pumped 8 ounces and let her milk sit....no fat, not a drop.? Remember how things bypass the gut in these women after surgery?? So many of them are severely anemic and end up on iron infusions. And so many with the B12 issues.? I have been an IBCLC working for a hospital with over 400 births per month for 15 years.? I have done outpatient consults for over 15 years.? 

And the other mother whose poor baby underwent gametes of testing and biopsies also had an enormous supply and also had no fat in her milk.? No one thought to think about this mother's inability to absorb properly after her gastric bypass.? She breastfed two others before the surgery long term without problem.? So the Ped blamed the baby.? It was not the baby.? This mother also had iron and B12 absorption issues.? Not all of these moms do. 

What I am trying to say is we don't know enough about these women and they need followed carefully.? Most of them don't trust they can make good milk or any milk or enough milk.? So they don't even try.? Even with me at the bedside offering follow up support free once they are discharged, I rarely see them.? Some have told me they do have milk and it does have fat, but they don't trust it.? Usually because?a Dr has told them not to or their family.? 

I think there is much we are going to learn.? I think there are many studies that need done.? I think someone should take on the challenge of studying their milk.? I think some can do just fine and others have issues.? The women I have seen that see fat in their milk have no trouble with B12 absorption or iron.? 

Just wanted you to know I know all about emptying of breasts and that was never the issue.

Pamela Hendrix BA, RNIV, IBCLC RLC
South Florida Hospital Based 

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