I read Andrea's post and a question came to mind that I've had for quite
awhile given the 'new' info on the relationship between low milk supply and
lack of breast changes during pregnancy.  First, let me say, Andrea, I feel
for this new mother.  It is not an easy road that she is on in the first
place, but to have to do it with minimal support from the dad makes it
doubly so.  I would want to know how often she is nursing at night and/or
pumping.  Since those are often the feedings that get skipped, substituted
(as in 'just give the baby a bottle'), and such, that might be a good place
to focus on.  Make sure she is nursing (even if that's nursing all night
which baby might be more amenable to) during the night as frequently as baby
wants or more, if she has to wake him/her.  That's also a low-key time to
get a baby to breast that might strenuously object during the hustle and
bustle and the light of day!  Skimping on night feedings can impact supply
by itself, so be sure she understands that.  The SNS is also a good tool for
getting  a reluctant baby to the breast.  It gives them immediate return on
their investment of sucking, so will keep them there longer.  I'd also make
sure mom isn't forcing baby.  Many posts have been written here on the
importance of skin to skin care for these babies that, first: doesn't
require them to DO something (as in, "Come on there's the milk, now all you
have to do is SUCK").  Reacclimate them to the warmth, comfort and safety of
mom's chest before trying to get baby to latch.  Also, have mom do the
bottles while holding baby at the breast so baby will make all those
associations, eg. Full tummy and mom's breast, feeding and satiety while
feeling mom's skin, smelling her and so on.

Now for my question: How much 'breast change' is enough?  Andrea said, ".
She said she had minimal breast changes (increase of a cup size) during
pregnancy."  I've always wondered but never really asked out loud how much
is enough.  I have heard women say they grew 3 cup sizes and I'm amazed at
that because I wore the same cup size as I did while non pregnant throughout
my breastfeeding of 4 children, 3 of whom never knew what a bottle was and
the other one only in the first rocky week of her life!  I've always been
small breasted, an 'almost A' comes closest to fitting and my nursing bras
were A's also.  Now, I did have breast changes, in fact I could tell a big
difference, but that wasn't reflected in bra size.  So, perhaps we need to
be careful when we talk about breast changes to check with mom about her
perception of breast changes!  That may or may not be reflected in a
difference in bra size.  At any rate, from my point of view, an increase of
one cup size is plenty of breast change to indicate an adequate milk supply!
Just my .02
Marsha

~~~~~~~~~~~~~~~~~~~~~~~~~~~
Marsha Glass RN, BSN, IBCLC
Mothers have as powerful an influence over the welfare of future generations
as all other earthly causes combined.
John S. C. Abbot
~~~~~~~~~~~~~~~~~~~~~~~~~~~

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