Re: Yaffa Stark's case, I want to know if she has an electronic scale (like
Medela's baby weigh.)  If so, I recommend that she get a before-after
weight and also time how long on breast baby is before she starts to pull
off.  It may be a combination of too-quick ending of otherwise adequate
feed and/or too short feed, and/or ineffective feed.  Also, you need to
find out what kind of milk transfer (volume) is occurring. Best way to do
that is to have mom and baby come in, weigh baby to "see what she weighs
today,"  Then have mom nurse baby and you time when baby starts to pull
off. Ask mom to tell you when she feels baby starting to pinch breast
before pulling off, thus causing the "wedging" you are talking about.
After feed is completed (both sides if you wish), then say, "let's see what
the baby took."  Then weigh baby again--in same amount of clothes you got
first weight (nude, with diaper, or with more).  That should give you a
decent idea how much milk baby actually took.

Then find out how much like other feeds this one was.

KGAuerbach


Re: Karen Page's mom with oral contraceptives. You said baby is now 8
weeks. How old was baby when mother began taking the oc's? Which one is she
on?  Although the so-called "mini" pill is not supposed to affect milk
production, if she is not on that, this may be the reason. One of the MDs
on Lactnet may wish to discuss which pills are least likely to generate
such a response.

Remember, too, that every mother reacts differently. While MOST women may
notice no change in milk production/volume/infant weight gain, some people
are more sensitive than others.  If it were my client, I would ask her to
immediatley to to some other form of birth control. If she can't get into
her MD for a diaphragm, suggest foam and condoms NOW along with increased
breastfeeding. If she is still amenorrheic, likelihood of pregnancy is
still QUITE LOW. (See Kathy Kennedy's excellent chapter in BFL on
fertility, contraception. She talks about the double protection period when
mothers are amenorrheic and using contraceptive methods.  This may help
mother to understand how to protect herself while also preserving her milk
production and breastfeeding relationship.

KGA

         %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
         %%  Kathleen G. Auerbach, PhD, IBCLC    %%
         %%        Lactation Services            %%
         %%        Homewood, Illinois            %%
         %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%