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From:
Gail Hertz <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 17 Apr 2013 23:08:38 -0400
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It seems the argument here is that if you mention a potential problem, it will become a self fulfilling prophesy, and therefore ruin a mom's chance if successfully Breastfeeding. I am a ped, so I tend to see people after the fact, as opposed to an OB who would possible see a mom before she attempts to breastfeed. I believe in telling moms all the information I have that applies to them. In this day and age, women have so much info (some wrong, some correct) that I feel that it is my job to give them factual, evidenced based, doctor info. I expect the same from my physician. Moms know if their breasts look "different" from their girlfriends breasts. They have already heard horror stories about Breastfeeding. They come to me to hear the truth. And the truth is that sometimes we don't know until we try. 

Gail Hertz
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On Apr 17, 2013, at 9:44 PM, Karleen Gribble <[log in to unmask]> wrote:

> But Celina, by definition the two women that were able to make enough milk did not have IGT. It's 30-80% of women who believe that they are not able to make enough milk for their babies. It seems that being female is a risk factor for making insufficient milk. I have seen LCs speak about risk factors such as having PCOS and being adoptive mothers as being predictive of a woman's ability to make enough milk for their baby when they are no such thing. We really don't know beforehand who is going to have problems and who is not. So much depends not just on the mother but on her baby and how they interact with one another. We should be looking at each individual situation. I have seen adoptive mothers have a terrible time stopping supplementing, not because they don't have enough milk but because they were counselled to be "realistic" about their ability to make milk. It does have an impact. Having a crystal ball would be lovely. It would be great to be able to predict who will have problems making enough milk but we just can't.
> Karleen Gribble
> Australia
> On 18/04/2013, at 10:29 AM, Celina Dykstra wrote:
> 
>> widely spaced breasts and breast development during pregnancy. For some reason 5 clients last year had IGT/Hypoplasia. Of those 5 I have met 2 mothers with widely spaced breasts, somewhat tubular shaped breasts, bulbous areolas, one with a 2 bra cup size growth during pregnancy and the other with a 1 cup size development. Both are producing enough. Both have tt'd babies, one had a revision of the anterior tie, who is doing great with breastfeeding, great milk supply - just had to adjust the angle of the latch.. cross cradle did not work as her nipple points to her elbow. The other chose not to go for further assessment after being told by an ENT that there are no restrictions (baby coming on and off frequently, clicking, spilling when bottle feeding, etc and a thick fleshy maxillary frenum wrapping right under the gum into the palate).. This mom is barely producing enough. I did give her information about both frenums and IGT. She is well armed with info and if things need looking at again, she won't be blindsided. 
>> 
>> For me, it is a matter of saying - "this is what I see, this may or may not make a difference, these are things to watch for, lets work on these things first and see what effect that has on breastfeeding". Every mom I have met with IGT says she wished her care providers, IBCLC, midwives etc would have told her right off the bat that they suspected IGT. Instead they jumped through a bunch of hoops doing x, y and z, when it was w all along.. and yes, we do have to address all the aspects. 
>> 
>> IMHO all women should have their breasts assessed during pregnancy and be given all the information. It would be like finding a lump in my breast which may or may not be cancer and not telling me what was found because I might lose hope. Moms don't get set up for failure by being given information if it is given factually. They get set up for failure by not being given the full assessment. 
>> 
>> It is a testament to our caring that none of us takes how to impart this information lightly. If there are any IGT or possible IGT moms on this board, what would you would prefer?
>> 
>> Celina Dykstra, IBCLC, LLLL
>> 
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