Subject: Re: Question about prolactin levels
'
Jerri,
Prolactin-raising galactogogues work when the issue at stake is low
prolactin. They are ineffective if this isn't the cause of the low supply
or if there are other issues. I note that you have confirmed there are no
retained placental fragments.
Does the mother have normal glandular development of the breasts? Is there
any history of lack of appropriate breast development in puberty,
cosmetically corrected by implants? Sometimes if it happened years ago,
mothers forget to mention the lack of development in giving their history,
unless asked a direct question.
Any endocrine disorders? Is she goal-driven and anxious?
Whether this is the case or not, focusing on the breastfeeding relationship
and on her baby, is constructive. You might like to try the idea of "a
holiday in bed with the baby", for  weekend or even just half a day, as
it can help turn things round if anxiety or tiredness is a factor. I learnt
this from LLL's newsletter in the 1960s, eventually drifted away from it,
and came back to it in the last 10 or 15 years. I've also seen it work with
turning round a bad case of mastitis and turning round mother-baby
frustration if the mother has made multiple efforts to latch and is tired
and ready to give up. I discuss what is do-able in her situation, e.g.
partner, family member or friend who can take over in the house for a few
hours and just let Mum just and breastfeed (and in this case, also express).
I'm sure you are giving this mother the reassurance she needs, that even a
small amount of her milk is providing her baby with goodies.
PS. I promised myself I'd never lurk on Lactnet, but either contribute or
go "nomail" However, since returning to "lactnet mail' a few weeks ago, I
have had little time to read messages, let alone respond. This is my first
post since I returned.
Virginia

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
Private Practice Lactation Consultant (cohort of 1985)
Ipswich (near Brisbane), Queensland, Australia

On Sat, Jul 2, 2016 at 2:00 PM, LACTNET automatic digest system <
[log in to unmask]> wrote:

> There are 2 messages totaling 59 lines in this issue.
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> Topics of the day:
>
>   1. puzzle
>   2. question about prolactin levels
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> Date:    Fri, 1 Jul 2016 07:11:53 -0500
> From:    Pat Young <[log in to unmask]>
> Subject: puzzle
>
> can a statistician among us, explain this to me???  Thanks, Pat in SNJ
>
> from a current study on gut microbiota and bronchiolitis in Pediatrics
>
> "We did not control for breastfeeding status because it was considered an
> ancestor variable of the association of interest (ie, the relationship
> between breastfeeding and likelihood of bronchiolitis may be mediated by
> gut microbiota), and adjustment of an ancestor variable would bias the
> inference toward the null."
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> ------------------------------
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> Date:    Fri, 1 Jul 2016 20:39:04 -0400
> From:    jerri walker <[log in to unmask]>
> Subject: question about prolactin levels
>
> Hi all,
> Needing a little help with figuring out best course of action with a
> mom--PTP. 3w PP with low supply. No health problems. Another provider
> suggested Reglan to increase supply. She came to me to discuss.  Saw
> hospital IBCLC and low production--test weight for milk intake was 6
grams.
> Trying lots of things--lactation cookies, fenugreek and pumping. Feeds 2-3
> hours then pumps and supplements. Gets about 1 ounce after feeding  in the
> morning, then a spoonful by the afternoon. Postpartum bleeding very light,
> almost gone. I was at birth and no issues with placental delivery. I did
> Prolactin levels and baseline was 136 and surge was 137. Any thoughts on
> use of galactogogues? Thanks for the help!!
> Jerri Walker, CNM, IBCLC
>
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