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    It Does a Baby Good {Part II}

    February 5, 2007 by Brandy Vencel

    Supplementation is necessary for moms like me. I do not produce enough milk. However, not every mother who isn’t producing enough milk is like me. Some moms aren’t producing due to specific causes, and if those causes are eliminated, milk supply will increase. They may even be able to be their baby’s sole source of nutrition in time.

    If five days go by after birth and a mother’s milk doesn’t come in {no engorgement, no leaking, etc.}, this is a warning sign. By this time, there should be other signs as well, including not enough wet and dirty diapers and extreme weight loss. If the baby is dehydrated, this will be accompanied by droopy skin, dry membranes inside the mouth and a sunken fontanelle. This is what my son looked like before he ended up in the NICU. His skin reminded me of an 80-year-old man.

    The first thing that should be checked is the baby’s latch. A really bad latch is usually identified before day five {due to the extreme pain for the mother}, but if it isn’t fixed the baby will have a hard time driving milk in in the first place. An improper latch can cause the breast not to empty properly, and if it doesn’t empty, it doesn’t get the “make more” signal. Emptiness is key to increasing milk supply for every mom.

    If baby is falling asleep while nursing, and attempts to wake the baby fail, a breast pump can be used to make sure that emptiness occurs {and the milk should be saved in case supplementation is ever necessary}. Of course, if there is no problem with the milk supply, there is no reason to do this. All the corrective measures and courses of action I will be discussing in this series are only necessary if there is a problem. Please don’t get the impression that this is what is involved in nursing for every mom. It’s not.

    If the latch is fine and the milk supply is still low, the next step is to find a doctor who will order hormonal blood tests. Not every doctor will do this, so it is important to find one who will. I would also suggest that one know one’s exact results and find a lactation consultant to interpret the tests. It has been my experience that doctors will say that a test result is “within normal” when a lactation consultant will say that it is not. Lactation consultants tend to know much more than doctors when it comes to the chemistry involved in nursing.

    By the way, just as it is important to find the right doctor in order to get the tests one needs, it is important to find the right lactation consultant as well. The lactation consultant needs to believe that the problem is as bad as it is or she isn’t going to be much help. I have had consultants who have told me just to go to bed with my baby and nurse on demand and that will solve the problem. Though this works for some mothers, it will not solve the problem for moms with issues as severe as mine.

    If a mother is having trouble finding a good lactation consultant who is able to go beyond the “nurse on demand and have a good latch” solution mentality, she should try calling a children’s hospital. The consultants at children’s hospitals have much more experience with unusual nursing difficulties, and they tend to do much more research because of this. They will often be more up-to-date on the latest experimental solutions available by prescription. More importantly, they will believe there is a real problem in the first place.

    The last step when trying to determine the cause of the short supply is to undergo a breast exam performed by a lactation consultant. About 1% of mothers have what is called Insufficient Glandular Tissue. This means they do not have enough of the proper plumbing to produce a full supply of milk.

    Even moms with IGT can nurse {I’m one of them}. In my next post, I will suggest ways to increase supply using herbs, prescription drugs, and other methods.


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