A quick report from the practical world: I recently spoke with a woman awaiting her first child, the result of a fourth IVF attempt after the first three failed. She was hospitalized in week 33 with threatening premature labor, and hoping to hang on until baby would have a better chance of avoiding an NICU stay. Among her worries was that one of her prenatal carers had told her 'it's unlikely you'll bring in a full milk supply, since you conceived by IVF'. She looked typically feminine to me, entirely normal body build, fat and hair distribution, so of course I asked whether she had a diagnosis that explained why she needed IVF. 'Endometriosis (confirmed by laparoscopy).' I told her that as far as I knew this had no connection with low milk supply, and that until proven otherwise we expected her course of breastfeeding to be more influenced by her own desire to breastfeed and the condition of her baby than by anything else. We talked about pumping in the beginning if baby was born so prematurely as to necessitate that, and we talked about how unfortunate the HCP's remark was. The woman was later discharged from hospital at nearly 35 weeks, as things had settled down and she was able to rest well at home. I was away for a time, but arrived at work after my trip to find that she had given birth to a healthy son weighing over 6 lb. at just 36 weeks. Because of clinical features in the case he was being treated prophylactically in the NICU with IV antibiotics, but otherwise no problems. He was also having some difficulty latching and was being fed banked milk until she got her own supply going. By the third day she was pumping 50-60 ml per session and engorged, and the first thing she said when I went in to congratulate her was 'You were RIGHT! I have MILK!' Naturally she is very happy about it, and she said how much it meant that someone who had a clue about lactation gave her a strong vote of confidence before she gave birth. By now she was ready to learn reverse pressure softening, and needed it. It helped, as it generally does. I think she would have managed in any case, but I am pleased that her last couple of weeks were less tense, and her start at breastfeeding more confident, because of a short conversation in late pregnancy. It takes so little sometimes, but it takes just as little to shake a woman's confidence in herself, especially when her childbearing is not uncomplicated at the outset. Rachel Myr Kristiansand, Norway *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html