Tricia talks about a mom whose baby number 8 is definitely  FTT.  What I'm 
going to say is not evidence based by any stretch of the  imagination, but 
it is something I have seen a couple of times in grand  multips.  Tricia, 
have you attempted to elicit where mom has to compress in  order to get a spray 
of milk?  How far back up the areola do you have to go  -- and -- can the 
baby get that far back on the breast tissue in order to elicit  that spray?  
It seems (and this is where the hunching comes in) that some  women -- 
certainly not all -- whose breasts have been well loved and well used  seem to 
have some stretching of the breast tissue and it makes me wonder if the  
"sweet spot" which used to be closer to the nipple-areolar junction is now  
farther back up the breast, making it difficult, if not nearly impossible, for  
some babies to compress there.  Some babies, depending on their size seem  to 
be able to compensate for that, and some seem to grow into it.  The fact  
that she can pump 30 mL after 30 minutes of breastfeeding tells me that the 
baby  is using most of the time at the breast just hanging out, waiting for a 
miracle  to occur, and that her milk supply has diminished considerably.  
 
This is where ac/pc weights would be so very useful.  But  I would try and 
elicit the sweet spot and see if baby is anywhere near there  when on the 
breast.
 
Jan Barger, RN, MA, IBCLC, FILCA
from Wheaton IL, but currently in Naples FL where it is -- by  FL standards 
-- COLD!!
 
 


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