Laurie, Pat and others...
Just sort of tagging a few comments to this IGT discussion...Laurie, do you
live in an area of Mississippi that is heavily polluted or has a lot of
agricultural chemical use? There's a strong connection to IGT and such
toxins so I was just curious about your locale.
Pat, you mentioned that no amount of galactagogues in the world will develop
glandular tissue and I just wanted to share that there are herbs (like
Goat's Rue) that do aid in glandular development, obviously pg hormones and
progesterone therapy are a different ball game but I do feel that it is
sometimes possible to build glandular tissue during lactation with
complimentary natural therapies.  One of my current IGT clients has gone
from a 4 finger spacing between the breasts to a snug 2 finger spacing in a
matter of 6 mos, very exciting to see and witness!  IGT cases can be multi
faceted and a comprehensive overview of hormones, past/current health/diet
Hx, etc are all factors. Of course we have to feed the baby first...but
don't forget rule #2 protect (and in these cases maximize) milk supply!
Bodies are amazing things and we can't assume that IGT moms will not make
any and/or enough milk, we just have to form a careful and proactive care
plan. I do think anticipatory guidance is valuable for such cases,
withholding info on IGT will do no good. Info can be presented in a gentle,
encouraging way as you enter into dialogue about your observations about
mom's breasts and what that may or may not mean for milk supply. This does
not mean telling moms they won't make adequate milk it means telling them
how their breast shape/size, etc could impact feeding and what red flags to
be aware of. I think it is a disservice that many prenatal providers never
even peek at or assess mom's breasts prenatally so that the discussion and
proactive nurturing care can begin even sooner.

Melissa Cole, IBCLC
Portland/Vancouver, USA

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