Hi Terri,
I would want some more information. For example, is this her first
lactation? Did she experience a noticeable difference in supply with prior
lactations?
I have heard of baby refusing breast when there was breast cancer - a rare
situation indeed. However if none of the other probable factors makes sense,
I would ask mom to get checked out, exam, ultrasound, and/or mammography.
But more than likely, I would be looking for some of the following: mild or
marked breast assymetry prior to lactating? Perhaps baby began favoring the
fuller side and gradually discontinued using the other side. As the less
used side involutes, it can get a salty taste.
Any difference in size, shape between the 2 nipples? Again, a baby could
easily favor the side with the more everted nipple. Potentially did the baby
have any positional issues, a difficult birth or in utero position or
presentation to lead baby to use one position or side, e.g. football hold on
one particular side?
Any history of mastitis in the lower producing side, either with this
lactation or a prior one?
Even with a mother lactating for a 6 month old, I would not expect that much
of a difference between sides, size A (involuting side) vs D cup, so I am
wondering about pre-existing less glandular tissue on the A side.
I do not think that having prolactin levels or using reglan would make a
difference. I have seen women with no breast pathology whose older baby
decided to prefer one side, and mother let the other dry up, and continued
unilaterally.
Or mother can express the A side, using that milk in cup or in baby's food.
Perhaps baby will take that side after filling up on the full side, and
nurse for comfort there.
Hope my thoughts are helpful to you,
Laurie
Laurie Wheeler, MN RN IBCLC
Mississippi USA
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