Hi Lactnetters,

I have been curious for quite some time, and decided to look back at the assessment sheets I use as I work with moms in hospital and if they come back for outpatient followup (or phone calls). I keep these sheets for 1 yr. I went back and reviewed these assessments for 6 months. I noted which pts were assessed as having a shape or feel of breasts that would make me wonder if they would have milk supply issues. Common descriptors were: "wide spaced, conical, bulbous areola, tubular, very flaccid, decreased glands in upper quadrants". I did not include mothers of babies who were premature because that would be an obvious confounder. Some of these mothers did not come for followup and could not be reached by phone (we always try if they don't come for f/u). Approx 1/3 of the mothers did have milk supply problems enough to require large amounts of supplementation, some discontinued bf due to lack of production, several babies had high levels of bilirubin and a few had 11 - 14% wt loss at the early f/u visit.
I did not check the mothers who appeared to have "well developed" breasts, so they very well could have had the same problems! This would make a very good prospective study.
I also had 2 moms with breast implants during the 6 month period. One of these moms made plenty milk and baby gained well (she said she was "completely flat-chested" prior to implants, a size A to C. The other mom said she was A to C cup also but made insufficient milk.
Of course, free unlimited bf help at our clinic is provided but I did not note who/how many took advantage and of what interventions might have been tried. It was interesting to me that approx 2/3 of the "worrisome" to me breasts did just fine, and this was not what I expected to find. I did not keep track of the numbers but when I have more energy I just might do that.
Just for your thoughts and comments.

Laurie Wheeler RN MN IBCLC
BMH-UC Breastfeeding Resource Center
 "Opinions expressed above are not necessarily those of BMH-Union County or Baptist Memorial Healthcare Corporation."


Baptist 100. Well beyond a century.

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