My first encounter with IGT was a mom pregnant with her third child.  She
made a prenatal appointment to see what she could do to avoid the hurdles
that troubled her with the first two babies.  No one had ever said anything
to her about IGT.  With her husband chiming in from time to time we
collected a very detailed history.  There were a couple possible red flags,
but nothing huge.  After those were thoroughly discussed I asked her if I
could have a look at her breasts.  It was so incredibly obvious.
Textbook.  And for her, given her situation, my frankness was freeing
rather than painful.

She has since had several other children, and her milk supply has not
increased much.  But with knowledge (and the freedom to drop the guilt that
she had done something wrong somewhere) she was able to maximize what milk
she was able to provide, while not risking too much neonatal weight loss.

The only specific counseling technique, per se, that I used other than
taking things slowly and listening, was to explicitly acknowledge that
there would be a grieving process and it was completely legitimate for her
to handle that however she needed to.

Lynn Carter OFS IBCLC
Missouri, USA

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