I really appreciated Jeanne Mitchell's vivid and horrifying descriptions of
the tragedy of the Guatemala earthquake.  Stress such as this, which results
from intense, sudden, and very frightening episodes has, of course, been
identified in the literature for a long time as a cause for losing ones
milk.  There is a very early case report of a "coaching accident" where a
stage coach carrying a nursing lady over-turned, and the woman immediately
lost her milk.  However, in the normal course of events, we seldom see such
violent and immediate trauma.

Everybody has a certain amount of stress after the birth of a baby, and
there are admittedly incidents of family violence which people can be
awfully clever about masking.  But even in cases where I have suspected or
mothers have let me know about such circumstances, they have been producing
milk.  Maybe less than normal, but something.  The interesting and striking
fact of this woman's situation is the total absence of any secretion at
all -- no post-partum breast changes, no drops.  Not from a pump, not with
hand expression, and no intake during test weights.  This in a woman with a
happy history of bfg with the previous child.  In the case I am reporting
about, there is no observable stress, nor reported stress, nor even inferred
stress.  I can only trust my own perceptions and the word of the mother.
She's not that stressed.  In some ways, calling up the specter of stress (in
the absence of earth quakes) is kind of a blame the victim thing.  I think
that the failure  of to lactate following an uncomplicated delivery is a
medical symptom, and I can't for the life of me see why her MD isn't more
excited about it.
Barbara


Barbara Wilson-Clay BSEd., IBCLC
Private Practice, Austin Texas
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