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From:
Diane Wiessinger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 29 Jul 1998 01:48:42 -0500
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Barbara -

One of my clients happened to have a prolactin level checked during
pregnancy.  It was normal for a non-pregnant woman, and should have been
many times higher (Lawrence, p 62).  We decided that since pre-birth
"prolactin is essential for complete lobulo-alveolar development" (Lawrence
p 61), the breast enlargement (from large to larger) that she experienced
during pg must simply have been incomplete.   We'd never have come to that
conclusion based on her *post-birth* prolactin levels, which were pretty
normal.

Since she was also having great difficulty getting her baby to latch,
especially with the SNS, she stopped after several weeks.  It was only
later that it really hit me that she was in the same position as an
adoptive mom - plenty of baby, not enough lactiferous tissue - and that she
could have done the same thing an adoptive mom does:  grow it.  Had I
thought this thru and encouraged her, she might have stuck with it and seen
a gradual increase in milk.

Another source of low milk I *think* I've seen this spring is related to
greater-than-average blood loss at birth.  Not enough to be considered
Sheehan's, but apparently enough to slow lactogenesis.  All 3 of the women
in whom I think I saw this went on to develop full (though barely, and
supported by fenugreek) supplies by 2 - 3 months.  But good nursing and
pumping didn't seem to make much difference in the early weeks.  It took
overall rest and recovery time.  This one was new to me, but is discussed
by Verity Livingstone JHL 11(2): 123-126 and JHL 12(3) Letters.  One of the
moms had nursed her 1st w/ abundant milk, and knew from Day 2 this time
that "something was different."

Diane Wiessinger, MS, IBCLC, LLLL  Ithaca, NY

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