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Subject:
From:
Liane Varnes <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 15 Jan 2009 07:13:12 -0800
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Good day to you, Wise Ones!
I am a Peer Breastfeeding Counselor with WIC, recently hired FT. Have been volunteering for many years. Here is the issue:
I have a mom who is due to deliver her 10th child (1 set of twins among them) in 3-4 weeks. She has just contacted us so we are brainstorming to know what path to take to help her avoid any pitfalls concerning her hx of low milk supply. Her three most recent have been unmedicated water births. Six of her children were born at home but she plans to have a hospital water birth with this one. 
I have only spoken to this mom on telephone, although I have a home visit planned for next week. I work under supervision of an IBCLC, who is familiar with this mom from past. My boss (the IBCLC) has met with this mom and says her breasts are rather tubular. Mom is of slightly above average weight and is 42 years old. She is nursing her 21 month old about 3x a day, and reports she finds it uncomfortable right now, but is hoping to regain some of the joy of nursing that child after the baby is born. Mom is wary of medical interventions, will only supplement with "raw" soy milk, rice milk (or should I say juice), or goat's milk. She is holistically oriented. All of her children have had low weight issues and she has been compelled to supplement all. She does not routinely sleep with her babies, although she does keep them in the same room. When she does bring them to bed, she is in the habit of tightly swaddling them. She has had her thyroid levels checked
 in the past with results of normal levels. She has no hx of anemia. 
She has taken herbal galactagogues in the past and has used breast compressions while nursing. She says she notices "some" difference from these things. 
We are brainstorming to come up with a plan for her to follow in first days/weeks, to hopefully avoid the problems she's had in the past. Although her technique may need some adjustments, it seems clear to me that there is something metabolically or physiologically going on that's not been identified. So far, we plan to urge her to hyperlactate in the first 10 days or so by beginning pumping at day three and then assessing at 10 days post partum. Mom spends a lot of bonding time with baby in first hours, but seemed intrigued when I spoke to her about unswaddling baby and concentrating on lots of STS time well after birth. We are all studying to come up with a game plan and I just wanted to put this out there in hopes that some of you might have some ideas that would help us identify the problem. 
Basically, with 10 kids, I consider this woman knows plenty about nursing. She is also a self-study, though with 9 kids, there's not a lot of time for that, I expect. She has asked us -- albeit a little late in the pregnancy -- to help her start out with the optimal situation in order to try to avoid the problems she's had in the past. I am enjoying the learning experience, personally. 
I'll be looking forward to any pearls of wisdom any of you might have to share. Thank you in advance.
Liane Varnes
Lactivist
Peer Breastfeeding Counselor
Ga. PH District 2 WIC 
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