Hi Lactnetters,
I received a question from on online mom (I volunteer on a Web site) about
low milk supply and subsequently received her permission to post her
problem to the list. She is about 38 weeks pregnant with her third child
and had supply problems with the previous two; she is wondering what else
she can try this time around to make it work. From her emails, she sounds
like she worked hard and did everything "right." (However, I'm still vague
on how much she was supplementing or actually needing to supplement,
because she said that although her first son didn't seem satisfied, he was
gaining weight and his output was okay.) We'd appreciate any ideas! Oh,
and I'm familiar with the Pediatrics study (kind of old now) about using
transillumination to determine insufficient glandular tissue, but does
anybody actually do this? How is insuffient tissue truly determined, other
than by "circumstantial evidence"?
Here's her email:
<<I did work closely with a highly respected lactation consultant in my
area during both of my previous breastfeeding experiences. It was actually
because of her that I realized I had an under active thyroid and was put
on Synthroid to regulate it. She made sure that my boys were latched on
well and there was no obvious reason why my milk supply would be low. She
is also the one who first had me put on Reglan to try to increase my
supply. I had pretty severe side effects from that so she encouraged my
doctor to work with a Canadian pharmacy to prescribe domperidone. I was on
that for some time but did not notice the increase in supply that everyone
said I would. I didn't have any side effects though. After being on this
for some time, my doctor checked my prolactin levels and discovered they
were very high. Probably from the combination of the medication and the
fact that I was pumping with a hospital grade double breast pump after
every attempt at feeding. She also set me up with the nursing
supplementer that you mentioned in your e-mail.
<<With my first son, I always suspected that I had a low supply because I
never really felt my milk come in, I never really felt full (even if the
baby slept through a feeding). Although the baby was gaining weight and
output seemed OK he didn't seem satisfied much of the time. I never heard
or saw him swallow much or felt my milk let down. Also, when I would pump,
I would get next to nothing out of either breast. I continued to
breastfeed however because everyone said it was normal for new nursing
moms to think they didn't have enough milk. It wasn't until my son was
about 5-6 weeks old that I started to know that something was wrong. I
would put him to the breast and he would latch on great. He would
vigorously try to nurse for a few minutes and then come off the breast.
When I would try to express milk by hand to get him started, I would get
nothing and my breasts would definitely feel empty.
<<With my second son, having much more experience, I knew much sooner that
I didn't have the supply I should. Again, I waited days and never felt my
milk come in or my breasts get full. There was really no change in the
size of my breast from pregnancy. He was unsatisfied much earlier that my
other son and was fussy most of the time until I supplemented with water
or formula. Although I tried very hard to not supplement, I feared I may
never have enough milk to satisfy him. I pumped, tried to continue
breastfeeding and supplemented with bottles for a couple of months until
there really was no milk left to even offer him. I never tried
medications with this one, nor did I have my prolactin levels checked. I
did however work closely with my doctor to be sure that my thyroid was not
low.
<<I am really hoping to discover some new answers this time around. I am
curious about the possibility that I may be one of the few lacking enough
milk-producing glandular tissue to produce a full supply. How would I know
if that is my problem? Would my breast look different somehow? I do have a
smaller chest (cup size=small B) but I wouldn't say they are shaped
differently or unusual in any way.
<<Thank you again for your time and for using your connection to other
lactation consultants to search for a possible answer for me.>>
What do you think? Maybe a combination of things, including small storage
capacity? Could her hypothyroidism be the culprit even though it's well
controlled? Thanks for any ideas or suggestions!
Jennifer Herrin, RN, IBCLC
Germany
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
