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Lactation Information and Discussion <[log in to unmask]>
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Thu, 23 Jul 2015 13:59:11 +0000
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I have seen this work:  double pump with a high quality pump - sorry for those who don't care for Medela but the Symphony is my personal favorite, goat's rue may be effective, massage and warmth.  Remember that breast development is not complete until the first 4 weeks (referencing Hartmann's work) and breast storage capacity may continue to mature until 8 weeks.  Some of the beta research has shown that some women don't convert to storing lactose until 42 days after delivery!  So there's hope.  Just giving the mama hope and encouragement and the right tools and she can overcome.  I always like to compare to moms who are adopting and inducing lactation.  Many of my moms pump for 2 or more weeks before seeing any more than a few drops - but go on to make adequate or near adequate supplies.   

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Debbie Dixon
Sent: Wednesday, July 22, 2015 10:52 PM
Subject: DELAYED / INHIBITED LACTOGENESIS II

Hi
I have a question re a mother who has a newborn 1 week old today. She has PCOS, diabetes (on Metformin tablets - not insulin) and is under the regular care of an endocrinologist. The birth was traumatic including morphine and an epidural. She had very little skin-to-skin time and not much was encouraged in the way of breastfeeding promotion.  The mother fully intended to breastfeed.
She had colostrum and was not offered an electric pump in hospital when the milk did not come in normally or other relevant breastfeeding advice. 
 From the sounds of it, very little encouragement was received from the midwives with breastfeeding.  She came home in tears from the hospital 2 days ago, devastated, having been told that she would not be able to breastfeed!!
At 1 week old, she now has mature milk but very small quantities. She has extremely high stress levels and now can't bear to put baby to breast but wants to breastfeed (I haven't worked out yet how strong that desire is at this stage due to what has happened). She had a visit today from the visiting midwife who did not even ask her to put baby to breast while she was there!! She did not suggest a hospital grade pump or any "real" help!!
Mother is currently only using a hand held pump (and no one from the hospital has made any comment on that)!!  

I am flabbergasted!!  I suspect this mother may not achieve a full supply, but the hospital staff appear to be not encouraging what capability there is!!

At this stage (1 week), is it still reasonable to expect a full / better supply that what there is with good lactation advice and double pumping with a hospital grade pump, to see what the breasts are actually capable of? At what point does involution occur especially for someone with this sort of endocrine history? (Was trying to find these answers in my books but couldn't find anything specific, so thought to post here).
Many thanks for any suggestions anyone can give.

Debra Dixon
IBCLC
Australia

 		 	   		  
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