I worked with 2 moms in December with insufficient milk supply.  Neither
experienced ANY breast fullness, both babies were suckling poorly by the
time I saw them (1 week) and still NO engorgement or fullness.  I don't know
if babies were suckling poorly from the beginning or had grown weak. With
pumping there were trickles of milk.

Moms used herbal galactagogues, pumped frequently, put babies to breast
often, one used SNS, (the other couldn't get her large soft breasts to
accomodate the SNS). One mom was supplementing with abm and the other with
donated breastmilk. They switched to the Classic pump and one did notice an
improvement, though small.

Mom A was supplementing with abm, had little support from family members
(particularly Grandma) and gave more and more supplement, pumped less and
less, and didn't insist on blood-test recommendations to check for thyroid
or hemoglobin problems (OB was disinterested) . Baby is now bottle feeding
(abm)and going to breast for comfort suckling.  But mom is going out a lot,
having resumed her very busy life.

Mom B, (the older large-breasted mom), worked and worked, had most-chaotic
days and nights, pumped a speck more each day, had blood work-up at 4 weeks
which came back normal ( she had begun an herbal iron supplement early on
because she had had significant blood loss at the birth.)  She now, at 6
weeks seems to have a sufficient supply and baby is feeding well at the
breast, gaining beautifully. She still supplements with breastmilk
sometimes, for security.

This mom told her large breasts, "I have put up with you two for 40 years
and now it is time for you to earn your keep.  I won't hear of you not
making milk for my precious baby!"  That's telling them, isn't it?!

I don't know why these moms didn't react normally to the birth, with
lactogenesis. I do wish there were a blood test, or such, for retained
placenta.  The blood loss could have been a factor in one mom, but the
other's birth was quite normal and the mom is very healthy--just slight
moisture in the colostrum phase and under 1/2 oz after 2 weeks of frequent
pumping.

I suspect that we will see more of this problem now that women are more
determined to continue in the face of early problems.  I think that it is
time for OBs, or whoever, to get serious about working with these moms on
possible causes of little or no breastmilk production.  Neither OBs in these
cases were eager to explore possibilities.  Mom B had to go to a family
practice MD to get genuine concern.

Most OBs just aren't interested in what happens after delivery. And Peds
often do not see Mom as their responsibility, so "insufficient milk supply"
doesn't belong to anyone.

What do we know of no mammary response to birth?

Retained placental fragments

Underactive thyroid

Excessive blood loss

Insufficient glandular tissue

Infertility from hormonal causes (?)

Age (?)

Could we be looking at 3rd generation of no breastfeeding?  Is there
life-long hormonal effect from a baby girl breastfeeding or not?

What about a woman reaching adulthood,conceiving, and giving birth without
ever holding an infant?

What about overdevelopment of the left brain and underdevelopment of the
right brain?

I'm getting a bit off the edge here...


Patricia Gima, IBLC
Milwaukee





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