Hi Debbie,
What's important here is that the mother has realistic expectations, as she
seems to have. She sounds a gem. In these situations, I'm always careful to
make no promises and give no estimates of time and volume. Mothers find it
encouraging to look for signs of breastmilk stools, as reassurance that the
baby really is getting at least some of their milk. I'm pleased that your
clinet that she has Diana West's book.
It may take her a month, perhaps longer, to reach the maximum production she
can manage. Since you are in Australia, you might find it helpful to access
a case history I published in Breastfeeding Review, which should be in your
ABA regional or branch library. The mother concerned wanted her case to be
published encourage other mothers to continuing breastfeeding with whatever
milk they can produce, while supplementing. She used a feeding tube and
later a bottle when her baby grew older. Some mothers can't face continuing
in this situation with a first baby, but are more mentally prepared with a
later baby.
Thorley V. Breast hypoplasia and breastfeeding: a case study. Breastfeeding
Review 2005; 13(2): 13-16.
You'll know more about her situation after you see the mother, take a
detailed history and examine her.
Virginia
in Brisbane, QLD, Ausrtralia,
where the jacaranda trees are in glroious bloom
----- Original Message -----
From: "Debbie Dixon" <>
To: <[log in to unmask]>
Sent: Saturday, October 12, 2013 11:10 PM
Subject: ?insufficient glandular tissue
Hello everyone
I have a client booked for next week who is currently 14 weeks pregnant with
her 2nd child. First breastfeeding experience did not go well (she had had a
good pregnancy with first baby but ended up with a posterior, non-descending
baby, a long 20-21 hours labour & an emergency CS). She took a long time to
recover after the birth and thought her milk never really came in well & was
topping up with a bottle.
When I took a preliminary history (I will of course take a much more
detailed one when I see her next week in person), she said she had "some"
breast changes but not anything substantial. She was unhappy with the
breastfeeding help she received at the time & felt nobody really directly
addressed the specific problem. As you probably all know, in Australia,
doctors are able to prescribe Domperidone, but the doctor she had at the
time was unwilling to prescribe it (and she found Metaclopramide useless).
She seems to be into herbal remedies, as she has taken raspberry leaf tea,
Alfalfa capsules, Fenugreek and Milk Thistle.
She hopes to go for VBAC with this birth and contacted me to get some
appropriate suggestions to be better prepared this time around. She has done
a lot of reading during this pregnancy & has read some of the Diana West
book "Making More MIlk". She seems a well educated woman & still feels that,
from what she has read & learnt, that she may not have sufficient glandular
tissue.
I will do a breast assessment along with a detailed history. I am assuming
(at this point, before seeing her, that the first baby's birth & post-natal
period has no doubt had a major impact on her breastfeeding experience), but
if it does turn out to be related to a lack of glandular tissue, what can I
offer her? I have never had a client with this before & I would only be
speaking from textbook knowledge. What have others found to be most helpful
to these women? Would ante-natal expressing from later in the pregnancy be
useful to store some milk in preparation?
Any ideas or suggestions much appreciated.
Debbie Dixon IBCLC CIMI PMC (infant massage)Dubbo NSW AUSTRALIA
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