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Subject:
From:
"Kermaline J. Cotterman" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 18 Jan 2001 22:54:58 -0500
Content-Type:
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<I agree with Jeanne that someone needs to acknowledge this mother's
concerns about not having milk.  And I agree with Denny's observation
that this woman's firm conviction on this point, without any evidence,
seems way beyond the norm, and in need of counseling and monitoring.>

As I read further comments on this, a light bulb goes on. We really don't
know, do we, whether her firm conviction is completely without any
evidence. Perhaps there is a missing piece of the puzzle that only she
and her physician are aware of.

Has this woman's OB perhaps discovered at the physical exam, that she has
some very rare congenital absence of the breasts, or nipples, or "trunk"
breasts, tubular breasts, etc. and told her so? In the case of tubular
breasts, perhaps prematurely?

I think this question needs to be delicately explored as the first part
of any counseling to be done. If so, can she be informed of the option of
a second opinion on the breast itself by someone who specializes in
breastfeeding and its problems?

It certainly need not be thought of as an insult to the obstetric
specialist's knowledge of obstetrics if someone specializing in
breastfeeding problems were to have a chance to repeat the physical
examination on the breast itself.

How she plans to feed any banked breast milk needs to be explored. If a
severe physical abnormality exists, I think she deserves an advance plan
that retains enjoyment of some of the hormonal and skin to skin effects
of breastfeeding.

<In less dramatic situations, when an expectant mother is "pre-worried"
about her supply, it's sometimes been helpful to point out that her body
has already been doing a beautiful job of feeding her baby for months,
and there's every reason to believe that it can continue to do so once
the baby is in her arms.>

However, it is important to delicately find out if a truly abnormal
situation exists, to avoid anything that might sound like a platitude to
her.

Just my $.02.

Jean
**********
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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