But this is the thing. Women who end up having IGT would have liked to have known beforehand. But an essential diagnostic criteria of IGT is that the woman involved is unable to make sufficient milk. So diagnosis of IGT after a previous birth is possible but not for a first because women can have physical characteristics that may be typical of IGT but have no problems. We simply do not know enough about IGT to be able to predict who will have problems with milk supply and who not before it actually happens. Anticipatory guidance is vital, close follow up of any woman who has red flags is also. In settings where this is not possible, there is a real problem.
Karleen Gribble
Australia
On 18/04/2013, at 1:54 AM, Barbara Latterner wrote:

> I agree with Diana that mothers want and need to know so they can receive  
> information and anticipatory guidance.  I've recently worked with a few  
> mothers, some who've had previous history of lactation insufficiency and they  
> were relieved to be able to plan ahead, receive information on 
> galactagogues,  donor milk, pumping guidance.  Having someone acknowledge that there may 
> be  an issue, listen to their stories, and help them through the grieving 
> process of  past disappointments is different than just saying to them 
> prenatally that they  may not be able to make enough milk for their baby.  Ongoing 
> support and  guidance is important before baby arrives and follow-up is a 
> must after baby is  born.

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