Hello, Mandy.
    The worst case of imbalance I ever worked with was  a mom who could pump 
6 oz. from one breast and only 1 oz. from the other  breast.  No trick we 
tried made any difference.  She *always* started  the baby on the 1-oz. side, so 
the baby would nurse more vigorously while still  hungry and maintain the 
amount that breast could make.  Mom was worried  that if she fed from the 6-oz. 
side first, baby wouldn't put much effort into  the 1-oz. side, and the supply 
would disappear altogether.  And we wanted  to do whatever we could to keep the 
risk of breast cancer lower in *both*  breasts, so wanted lactation to happen 
in both breasts to the extent  possible.
    Herbs and prescriptions would not have helped the  mother I worked with 
because, in her case, she made *enough* milk, just not  equally balanced.  Had 
she taken a galactogogue, there was every  possibility that she would then 
have had too much milk, at least for a while, on  the 6-oz. side until her body 
got the message that it wasn't needed and cut back  again.  We did try some 
food galactogogues in the early weeks, but it  didn't do anything for the 
lower-producing breast.  If the mother you are  working with has an *overall* low 
supply, then galactogogues can help, but the  mother may still experience an 
imbalance in amount between the two  breasts.
    One other question:  Have you checked to see  that mom doesn't need a 
different-sized breast flange for the pump on the side  that does not produce 
well?  If the breast flange she is using is either  too small or too large, that 
would impact her ability to produce enough milk  while pumping.  I have had 
quite a few moms who needed two breast flanges  of different sizes.  Although 
you told mom to switch sides while pumping,  if both of her breast flanges are 
the same size, and she needs one to be  different, you wouldn't have noticed 
any difference by switching sides during  the pumping.
    Dee  

Dee Kassing,  BS, MLS, IBCLC, RLC
Collinsville, Illinois, in central  USA


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