Coach Smith here to comment on Marsha Glass's client:
1. Milk removal - consistent, thorough and effective - is THE key to
establishing and maintaining milk supply. Get the mom pumping and/or
hand-expressing immediately if you haven't already done so. I would not rely
on this baby to effectively transfer enough milk to establish and maintain
milk production.
2. Milk supply is not primarily about the herbs, nor the supplementer. It's
only rarely (if ever) about what mom eats, drinks, or thinks about. The
primary driving force is milk removal. See Hartmann's articles cited below.
3. The NP may be unfamiliar with the therapy, concerned with turf (scope of
practice) issues, or both. If the main concern is clinical, then some good
references are in order. But regarding herbs as the primary way to increase
milk supply - see above.
4. If the friction is because of turf issues, then back off and look for a
more collaborative team-approach way of interacting. Make sure the baby's
positioning and latch are perfect. Keep mom and baby together. Get her
pumping. etc Do what you CAN do, keeping the NP and dietitian and everyone
else thoroughly involved.
5. Anybody can call themselves a "lactation consultant" because that term is
not (at least not yet) a legally protected term. However, the common
practice is to equate "lactation consultant" with International Board
Certified Lactation Consultant (IBCLC). IBCLC is a legally protected
title/term and no one should not be calling themselves an IBCLC unless they
have passed the exam.
6. Get a copy of Evidence-Based Practices for Breastfeeding in the First
Fourteen Days from ILCA (http://www.ilca.org/pub.html ) and give it to her.
Also download a copy of the AAP Policy on breastfeeding for additional
ammunition. And ask for their evidence too.
7. Read my article at http://www.bflrc.com/ljs/breastfeeding/MakeMilk.html
for more on milk synthesis.
Some of the best references for milk synthesis:
* Cox DB, Hartmann PE. Plasma prolactin and the control of milk synthesis in
women. Neuroendocrinology 1993;58. (Supp 1):H31.
* Cox DB, Owens RA, Hartmann PE. Blood and milk prolactin and the rate of
milk synthesis in women. Experimental Physiology 1996; 81:1007-1020.
* Cregan MD, Hartmann PE. Computerized breast measurement from conception to
weaning: clinical implications. J Hum Lact 1999; 15(2):89-96.
* Daly SEJ, Hartmann, PE: Infant demand and milk supply. Part 1: Infant
demand and milk supply in lactating women. Journal of Human Lactation
11:21-26.
* Daly SEJ, Hartmann, PE: Infant demand and milk supply. Part 2: The
short-term control of milk synthesis in lactating women. Journal of Human
Lactation 11:27-31, 1995.
* Daly SEJ, Kent JC, Huynh DQ, Owens RA, Alexander BF, Ng, KC, Hartmann PE.
The determination of short-term volume changes and the rate of synthesis of
human milk using computerized breast measurement. Experimental Physiology
1992; 77: 79-87.
* De Carvalho M, Robertson S, Friedman A, et al. Effect of frequent
breast_feeding on early milk production and infant weight gain. Pediatrics.
1983;72:307_311
* DeCoopman, Jan. Breastfeeding after pituitary resection: support for a
theory of autocrine control of milk supply? J Hum Lact 1993; 9(1):35-40
* Hartmann PE. Changes in human milk composition during the initiation of
lactation. Austral J Exper Biol and Med Sci 59: 101-114, 1981.
* Hartmann, PE and Kulski, JK. Changes in the composition of the mammary
secretion of women after abrupt termination of breastfeeding. J Physiol
(Lond) 74: 509-510, 1977.
* Healy DL, Rattigan S. Hartmann PE, et al. Prolactin in human milk:
correlation with lactose, total protein and alpha-lactalbumin levels. Am J.
Physiol 1980; 238: E83-E86.
* Kulski JK, Hartmann PE. Changes in human milk composition during the
initiation of lactation. Austral J Exper Biol and Med Sci 59: 101-114,
1981.
* Kulski JK, Smith M and Hartmann PE. Normal and caesarean section delivery
and the initiation of lactation in women. Austral J Exper Biol and Med Sci
1981; 59: 405-412.
* Neifert, M., McDonough, S.L. & Neville, M.C. (1981). Failure of
lactogenesis associated with placental retention. American Journal of
Obstetrics and Gynecology, 140, 477-478.
Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre www.bflrc.com
6540 Cedarview Ct., Dayton, OH 45459-1214 USA
(937) 438-9458 email [log in to unmask]
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