We are wired to breastfeed successfully, and if this mom can get pregnant, 
she is likely to be able to breastfeed successfully.

I have found that the commonest reasons for unsuccessful breastfeeding are 
more to do with expectations and lifestyle  (expecting babies to behave like 
artificially fed babies and feeding them on schedule, or "on demand" but not 
more frequently than 3 hourly) than with pathology.  I also suspect that 
moms with small breasts may have lower capacity, and do better when feeding 
very frequently.  I hear that she said the baby was on her breast 24 hours a 
day, but I have often heard that, and when I visit and watch, I see that 
what actually happens that baby is getting a pacifier and being rocked a lot 
instead of being put onto the breast.  If the nipples were a problem (baby 
not latching properly, not getting enough milk effectively, so not gaining 
weight), then giving them a longer time to become a successful breastfeeding 
couple will help.  They can be tided over with supplementing temporarily 
with expressed mom's milk in the beginning, until the baby manages a good 
latch on the breast.

Give her lots of support, see that she's well informed with realistic 
expectations, help her cope with her large nipples, and most importantly, 
expect her to succeed. Your confidence is contagious and will help more than 
anything.

Nan Jolly MB BCh. IBCLC. LLLL
Port Elizabeth, South Africa


> Last week at my LLL meeting, a mother-to-be, expecting her 3rd baby in 
> July,
> came into the room.  I was immediately taken with her appearance -- she 
> was
> very tall, with a large frame, and extremely masculine features (facial 
> and
> bodily).  Her hands were especially large.
>
> As the meeting discussion progressed this mother shared that she had been
> unsuccessful in breastfeeding her other two children -- that the 2nd baby
> had been "very happy" at the breast "24 hours a day" but was diagnosed
> failure-to-thrive after the first 10 days (having lost more than 10% of
> birthweight and not gained anything back, also did not poop at all after
> discharge from the hospital).  This mother had good lactation support 
> after
> that 2nd baby.  She claimed her "huge nipples" were the problem.
>
> My immediate suspicion was that she has hypoplasia, and I looked at her
> breasts after the meeting to see for myself.  If there is hypoplasia, it 
> was
> mild -- maybe type 1 or 2.  My gut, though, is telling me that there might
> be some other hormonal issues at play because of her extremely masculine
> appearance.  I'm posting here to see if there might be some research on 
> this
> out there that I can review, or if anyone else has seen a similar 
> situation.
>
> She denied any PCOS or diabetic issues, reported "very little" breast
> changes during pregnancy or postpartum.  She says she is the only woman in
> her family who did not breastfeed a baby and she feels like she's missing
> out on a lot -- she really wants to breastfeed this time.  I'm giving her 
> as
> much information as I can for her to share with her support people (LCs,
> doctors, friends, etc.) but my gut is telling me I'm missing a very big
> piece of the puzzle.
>
> Thanks so much for any insights you can share!
>
> --Diana in NY
>
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