Heather,

        Something I have noticed over the last 5 years is a compromised
lactogenesis in mothers who conceived with fertility assistance.  The
hospital I work for has a fertility clinic connected with it as well as a
high risk pregnancy unit (many of the clients are moms who conceive
multiples).  Because of this, we have a fair percentage of postpartum women
who conceived with fertility assistance.  My colleagues and I have seen
this trend so often, that we now ask a client who is having difficulty with
lactogenesis if she conceived with fertility assistance.  It sounds like
you took all the right steps in supporting your lactogenesis.  Therefore, I
think the problem may lie in the fact that you needed the fertility
assistance.  I am not aware of any studies that support this theory at this
point.  Good topic for a future study!  I believe the thought is that if
hormones for conception needed enhancement; the lactation hormones may be
low as well.  This is assuming you received the fertility assistance and
not your husband.  No breast changes in pregnancy is another indicator of
there being  a poor chance of lactogenesis.

        Has anyone else on the list seen this trend with fertility moms?   Does
anyone have any more information?

                Donna Zitzelberger RN BSN IBCLC

> Hi!  I've been on this list for awhile and have learned so much --thank
you
> to everyone.  I just wanted to throw out some information and see what
other
> people thought.
> I just recently had a beautiful baby boy after 3 years of trying to
conceive
> (I went to a fertility clinic) and had planned to breastfeed my baby.  At
> day five I thought my milk came in as I was a little tight around the
areola
> only and that is all that happened.  My baby lost tons of weight and I
> breastfed and pumped following to increase my supply with no success.  He
> nurse constantly and I feel continuously guilty that he was hungry for the
> first 6 weeks before I had to supp (Dr. orders!) I had a pump from the
> hospital that I work.  I forgot to mention that I am a  OB nurse that
works
> in a facility that does LD, postpartum and newborn nursery.  My son
finally
> regained his birth weight at 6 weeks (by that time I was supping him with
> formula by cup but only after he nursed)  My latching and overall breast
> feeding tech was evaluated with no problems detected.  I breastfed for 3
> months and always had to supp him following his breastfeeding.  He was
never
> limited to his access at the breast .  I had good support of my husband,
> family, and medical personnel.
>   My question is that if it happened once could it happen again for a
future
> pregnancy?  I truly did everything in my power and followed the advice of
> lactation consultants to the letter.  Unfortunalty I feel so guilty that I
> dwell on it constantly.  I wonder if I have made anyone feel as bad as I
do
> at work inadvertently because I really support the feeding choice of the
mum
> but feel bad that my feeding choice never happened.  I took both
domperidone
> and reglan to increase my supply and the total that I could pump of that
my
> son test weighed for was 58 cc.  Also during my pregnancy my breasts did
not
> change at all.  I would appreciate any comments on this and would be
> interested in information regarding the 1% that is unable to breastfeed.
My
> son comfort nursed till he was 14 weeks then refused.   Heather

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