Bettina,

Years ago when I worked with our local childbirth education association,
one of the active members was a woman who had spherocytosis. She and all
4 of her sons had had spleenectomies, and she had had unremarkable
childbirth and breastfeeding experiences. It does not make sense to me
that this could be a direct cause of anyone not initiating a milk supply.

I think you are on to something when you say:
<She is convinced that her =
spherocytosis is the reason for her suppressed lactation.. . . . .
. . . . Having something other than herself to blame is =
helping her process alot of angry energy.>

Does she really want to breastfeed, or does she only wish that she could
want to, in order to reinforce her delay in moving out of the victim role
on into being a survivor?

Perhaps the "blame" lies elsewhere. Are her milk sinuses palpable, or are
they located 2" or more deep behind the nipple? Much of the nerve
ennervation responsible for stimulating oxytocin and prolactin release
seems to be in the walls of the milk sinuses. If the baby's mouth is not
yet large enough to reach them with vigor, this might result in less than
ideal prolactin surges and MERs, as well as inefficient milk removal.

If the milk sinuses are deeper than 1-1 1/2 inches, a larger pump flange
may compress them more effectively to speed the process of stimulating
prolactin surges. Would she consider using a hospital grade double
electric pump if possible 4-6 or more times a day for a week or so in
addition to breastfeeding to see if that would change the situation?
Without the main stimulus of consistent, continued efficient milk
removal, I doubt galactagogues will help much

I heard today of a mother with an established milk supply but with deep
sinuses and poor yield with a double pump. She obtained just one large
flange and also used one regular. She alternated which breast she used
the large flange on and was soon consistently getting 4 ounces from the
side where she was using the large flange and 1 ounce on whichever side
she was using the regular size.

Just my suggestion. Good luck. I think this mother is in special need of
some good vibes from her body to help her move this other experience into
her long-term memory and move on with her mothering, and help her
children adjust to their heredity by example.

Thank heaven she lives in a century and a nation where spherocytosis can
be diagnosed promptly and surgery safely performed to help people survive
and live a normal life. I hope she can be helped to adjust to "an
attitude of gratitude"!

Jean
********************

K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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