---------------------
Forwarded message:
Subj:    insufficient glandular tissue
Date:    96-10-29 15:27:56 EST
From:    Caren rn
To:      listserv@librarylactnet
CC:      Caren rn

Hi all.  I have a Mom who really wants to breast feed and is just not making
enough milk.  She Had breast reduction surgery 14 years ago on 1 side because
it was much larger than the other side.  She has no idea what was cut.  There
is a visible scar below the breast and around the top half of the areolar.
 She seems to be producing more milk on the side she had surgery on.  I was
asked to see her on day 10 because baby had lost over 1lb since birth.  The
Pediatrician had given her a feeding tube and syringe to supplement with.
 Baby was latched well-a bit shallow though whcih was easily corrected.  Mom
said she was initially sore, cracked and bleeding but that was resolved by
the time I saw her.  After 3 days had a 2oz  gain with supplement.  We hooked
her up with an SNs because she was supplementing with a bottle and she was
amenable to using that every other feed.  Baby nursing on and off for hours
at a time.  I had her double pump 1 hr after supplementing to try and
Increase supply.  She would only get a feww drops.  Mom said she felt like
the baby was swallowing more and her breasts were starting to feel fuller
before feeds if the baby waited two hours between feeds.  Milk is visible
when mom hand expresses.  Milk only drips out on the smaller side with the
pump, does spray out of the reduced side but only for a short time.  4 days
later baby lost 1 oz.  Doctor wants them to supplement every feed.  This
peds. group is very supportive.  Mom upset.  She thinks her supply is
increasing and is afraid that if she gives more ABM she will decrease what
she has.  She was giving about six oz per day.  She will increase to about 10
oz per day.  Does any one have any other suggestions for this very motivated
mom?  Her OB does not seem very supportive.  He thinks she should just bottle
feed if she can't make the milk.

Thanks in advance
Caren Goldstein RNC IBCLC