I was very interested to see the neat Dutch study on stretch marks (nice
work, Gonneke), and the interesting comments made by Kathleen Huggins, one
of the authors of the new study on markers for insufficient breast
development and its relationship to breastfeeding.  Kathleen described her
protocol for communicating with mothers with markers for this and other
problems.  She states that she and the others in her institution have red
flag issues which, when observed, prompt them to inform mothers that they
would like to arrange early follow-up to make sure no problems are occuring.
What a nice service and what a reassuring way to provide care.  This can be
phrased "Just to be on the safe side..." and no one needs to be unduly
alarmed.  It is true that most of the time the extra caution is unnecessary,
but in the few cases where it is warrented, the early intervention gives the
best chance to remediate a situation, or to at least maximize a mother's
best potential.

I was also interested that Kathleen Huggins mentioned nipples larger than a
quarter in diameter as a risk factor.  I have been measuring nipples lately
(with an engineer's circle template) and finding the same thing to be true.
A quarter is an American coin, 15/16 in.  or 23.8 mm.  If the nipple tissue
is elastic and pliable, and if infant is a good size this may not be a
problem, but a fibrous or "meaty" nipple texture and a large size is real
trouble for some babies.


Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com

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