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Subject:
From:
"Catherine Watson Genna BS, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 9 Jun 2011 11:02:23 -0400
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Read Nancy Mohrbacher's article on the "Magic Number" in Clinical 
Lactation volume 2 number 1. It is available online at 
http://www.clinicallactation.org . (Those of you who are USLCA members 
receive this new journal as a member benefit, others can subscribe).

  Mothers vary in their milk storage capacity, and mothers with smaller 
'warehouses' need to bf much more often to maintain milk production. 
When  a mother suddenly "runs out of milk" I generally plot a growth 
chart for the baby (using the WHO charts) to help pinpoint when the 
problem started. Almost always there was a gradual decline. This means 
that the breast was not being emptied frequently enough or thoroughly 
enough for a very long time before the irreversible stage of involution 
was triggered.

The desire to "episode feed" at long intervals leads some moms to not be 
able to make sufficient milk. I've had moms in my practice who could 
only make 1 oz per hour with lots of stimulation, but their babies have 
done well nursing every hour. Not every mother is willing to do this, of 
course, but a surprising number are.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com


On 6/2/2011 10:34 PM, Sima Leah Duato wrote:
> I, too, have worked with mothers whose milk did disappear at around 3-4 months.  Nothing to indicate any mismanagement, we tried several galactogogues, super switch feeds and more often, pumping, etc.  It seems to me that once the milk production is not being exclusively by hormones, and moves into the supply and demand phase, somehow production stops.  Theses women have no indication of hypoplasia, at least that i understand.  and their supply to begin with is small.  these are mothers with several children and the pattern continues with each one.
>
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