>In a message dated 5/4/2005 7:44:35 A.M. Mountain Daylight Time,
>[log in to unmask] writes:
>
>His birth weight was 7 lbs even and she has not had a follow up
>>weight (peds appt. tomorrow) but seems to think he is gaining weight. He
>is
>>alert and active when awake, nurses readily and has no signs of
>dehydration.
>
>Mom is only pumping about one oz or less each session with a PNS. She told
>me that last night she pumped a little over 2oz. but only 1 oz again this
>morning. She is supplementing him with ABM (about 2oz each feed).
Thanks for responding, Christine.
It seems from your posts that the only reason you are thinking about
no lactogenesis 2 is the lack of obvious breast changes, and the
small amounts of breastmilk pumped.
I respectfully suggest that neither of these points, separately or
together, indicate that this very rare phenomenon has occured,
especially in the absence of any other information. There has, I take
it, been no observation of a feed, and we don't know what the baby
weighs - although with this large amount of ABM, in addition to what
he gets at the breast, plus the breastmilk she's pumped which she is
presumably giving him, one might expect a normal weight gain. You
don't give any info about urine and stools, though again with this
amount of milk going in, these are presumably normal. You also don't
say at what stage she started supplementing.
>
>
>The labs would look for an elevated level of testosterone which could be an
>indication of luten ovarian cysts. Some studies have indicated that if a
>woman has elevated testosterone and delayed lactogenisis II there is a
>preliminary diagnosis of luten ovarian cysts. There are cases
>where they cysts
>resolve post-partum and once the testosterone levels fall the woman then goes
>through lactogenisis II. This can take about 30 days. If that is
>the case with
>this mother then we have good reason to continue to encourage her to pump and
>put the baby to breast in the hope that she will, eventually, produce a full
>milk supply or close to a full milk supply.
>If the labs come back showing normal hormone levels then we look at other
>causes; latch, infrequent pumping etc.
Would you not want to look at a feed before you took bloods for a lab
test? I am not familiar with hormonal profiles and what they might
indicate about breastmilk production, sorry, and I would go for the
simpler option, which is to assume that lactogenesis II has indeed
occured, that the lack of obvious breast changes are a variation on
normal, and that early supplementing and (possibly) poor milk
transfer leading to ineffective stimulation have combined to depress
her supply.
To turn this round, my approach would be to have her baby weighed,
her position and attachment observed and amended if necessary, a plan
to gradually reduce the ABM supplements started, far more frequent bf
and skin to skin, and then possibly pumping if there is any time to
do it. With this amount of supplementing, she doesn't have a hope of
building up to a full supply....whether lactogenesis 2 has happened
or not.
I share your frustrations at the way lack of support from doctors can
undermine breastfeeding :(
Heather Welford Neil
NCT bfc, tutor, UK
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
