Riva writes:
What is interesting, in light of the discussion on pumping, she discovered
that she has a very delayed let down. When she pumps she has to continue
stimulation for over half and hour in order to get 80 cc.
~~~ I worked with a mom with a severely delayed letdown like this. It
kicked in later, was not something I saw when working with mom in the early days
( I always watch the mom pump at least once so I would have seen it). In
fact she never actually told me she did not let down for 30 minutes until
months later ( and I never knew to ask.) She made plenty of milk, it just
took forever to get it to release. I'm not sure if she was ever diagnosed by
a doctor, but at some point she told me she thought she had
hyperthyroidism ( figuring it out after talking to another mom, I think.) Looking back I
wonder if she had a form of Postpartum Thyroiditis. Her baby was
completely breastmilk fed on this pumped milk for about a year I think ( with
complementary foods in place then). Baby never did latch on and breastfeed no
matter what we tried. I think he had his own issues which she was not
supported in addressing so this just made everything more complicated. She was
able to keep up her supply expressing milk only 3 times a day for months. I
wonder if this mom you are talking about Riva has a thyroid issue going on.
As for why a baby with reflux would take a pacifier and not an "empty
breast", I wonder if baby simply developed a negative ( painful,
scary/breath-compromising) association with refluxing interrupting the previous good
experience of breastfeeding, and is now feeding only long enough to move away
from being overly hungry but then stopping rather than keep going til
satiation as before... Many babies are helped with CST when they have reflux
issues. Some moms offer a few sips of expressed milk from a little spoon or cup
to deliver the pain-killing aspects of mom's milk, soothe the burn, and
either then baby will breastfeed a little more, or at least get a little extra
at the end of a feeding ( quick hand expression after baby stops.)
Just some thoughts,
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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