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Subject:	Re: Tough situation for mom need input...
From:	"K. Jean Cotterman" <[log in to unmask]>
Reply To:	Lactation Information and Discussion <[log in to unmask]>
Date:	Tue, 13 Sep 2011 16:14:20 -0400
Content-Type:	text/plain
Parts/Attachments:	text/plain (41 lines)

Jaye,

In my experience, RPS held for about 20-30 seconds, has never failed to elicit an MER, showing signs within the next 60 seconds.

This client is in serious need of expert guidance on how to allow the FIL (feedback inhibitor of lactation) an expertly guided chance to work without risking mastitis. You didn't say anything about frank gigantomastia, so I am imagining that she is one of those mothers whom nature gifted with her full complement of secondary buds during her own embryonic period. Much of our experience, and most of our management strategies have been based on those mothers who for many possible reasons may not have had that developmental good fortune.

Guillette EA, et al, Altered Breast Development in Young Girls from an Agricultural Environment
Environmental Health Perspectives Volume 114, Number 3, March 2006

Gonneke (Carolyn van Veldhuisen) would be the consultant to contact for expert guidance. She is very willing, and was of great help once when another practitioner reached out for my help for a mom who "didn't get it" and kept up-regulating supply for a long time simply because she couldn't understand how her frequent pumping was a key part of the problem.

I recommend Gonneke's article:

Overabundant milk supply: an alternative way to intervene by full drainage and block feeding
Caroline GA van Veldhuizen-Staas
International Breastfeeding Journal 2007 2:11

This article is published under open access, meaning that you can read the full text without a subscription.

But I stress the need for your personal contact with Gonneke on this mom's situation.

K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC, Dayton OH

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