Re: Breast Reduction - low supply

[Guest guest]

Hi, ,

Yes, managing milk supply after reduction surgery doesn't differ much

from general low milk supply issues. You'll just want to do what

you've already recommended: maximize milk removal and consider

galactagogues, goat's rue in particular in addition to domperidone.

Also, be sure to rule out any baby-sided issues and screen for maternal

hormonal issues, as well. Baby taking so long to latch may be a red

flag for tongue problems. Reassure the mom that stress is not

likely to have a significant impact on her supply, but she can try

relaxation measures to help with let down. Also confidence will

build with time.

Quick answers to a complex situation, but hopefully this reassures you

that you're already on the right track.

At 03:33 PM 11/7/2008, Nicola O'Byrne wrote:

Hi again

Im looking for suggestions to help a client who had a breast

reduction

6 years ago. She had 6 1/2 lbs of tissue removed ( is that alot?) .

Its not something I have alot of experience working with but Im

guessing its the same as low supply ...am I right there or is this

going to be much harder to increase the supply? What should our

expectations be?

Ok so this mum just had her 2nd baby 2 weeks ago .

With her first baby she never produced any milk - so this time she

says she

would be happy to breastfeed 2 or 3 times per day. Only now.. the

baby

is refusing the breast - sometimes takes up to 40 minutes to latch .

Of course, just to confuse the issue , the baby has a tongue tie.

Its

not an option to get this clipped for another month at least (

nobody

available and mum not sure she wants to) .

She is supplementing with lots of formula , pumping but getting

drops

only .

SO the plan is .. try domperidone , increase pump flange size as she

has large nipples, start off feed with shield if baby wont latch

without , fill shield with milk if baby fights shield, skin to skin

as

much as possible (unfortunately the 2 year old is not coping well

with

the new arrival and has started to actually pull her own hair out)

so

the mums feels her own stress is affecting the supply too.

Ive gone though paced bottle feeding with the mum as she doesnt want

to use as supplementer ( she feels thats one step too far ).

Is there anything else to suggest apart from lots of support and

encouragement?

Thank you in advance for any answers - it helps just to write it

down

sometimes .

Nicola O'Byrne

www.breastfeedingsupport.ie

Dublin ,Ireland.

[Guest guest]

>>>

SO the plan is .. try domperidone , increase pump flange size as shehas large nipples, start off feed with shield if baby wont latchwithout , fill shield with milk if baby fights shield, skin to skin asmuch as possible (unfortunately the 2 year old is not coping well withthe new arrival and has started to actually pull her own hair out) sothe mums feels her own stress is affecting the supply too. Ive gone though paced bottle feeding with the mum as she doesnt wantto use as supplementer ( she feels thats one step too far ). Is there anything else to suggest apart from lots of support andencouragement? Thank you in advance for any answers - it helps just to write it downsometimes .

>>>>>>>>>>>>>>>>>>

do you have diana west's book "defining your own success" specifically about breastfeeding after reduction. in addition, she has a web site: www.bfar.org. if you haven't already, i strongly recommend you read the book and the web site.

the difference between BFAR and "regular" causes of low milk supply, is, not only might there be reduced glandular tissue, but more importantly, even if there is sufficient glandular tissue the OUTLETS for the ducts (through the nipples) may be severed, preventing the m ilk from getting out, thereby reducing milk supply even further, because the breasts fill up, and FIL takes over in addition to physical/mechanical reduction of milk supply.

it helps to know what kind of surgery was done (free nipple vs. pedicle) but in my experience, some BFAR moms end up with a great milk supply and others not - all the same approaches to building milk supply in any situation are helpful - including, and most especially, perhaps, giving it a good long while (up to a month of trying everything) to really assess full milk production capacity.

it's really too bad there is an unresolved tongue tie here, as that can really throw a wrench in the works in terms of optimizing milk supply. have you shared all the recent literature on tongue tie with her?

warmly, Lyla

MARKETPLACE

From kitchen basics to easy recipes - join the Group from Kraft Foods

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[Guest guest]

oh - wow - between the time i started my reply and the time i posted it - diana herself has chimed in! sorry for any duplication!

and diana - i believe she said that YES the baby ALSO has a tongue tie, not resolved... :-(

Lyla

[sPAM]Re: Breast Reduction - low supply

Hi, ,Yes, managing milk supply after reduction surgery doesn't differ much from general low milk supply issues. You'll just want to do what you've already recommended: maximize milk removal and consider galactagogues, goat's rue in particular in addition to domperidone. Also, be sure to rule out any baby-sided issues and screen for maternal hormonal issues, as well. Baby taking so long to latch may be a red flag for tongue problems. Reassure the mom that stress is not likely to have a significant impact on her supply, but she can try relaxation measures to help with let down. Also confidence will build with time.Quick answers to a complex situation, but hopefully this reassures you that you're already on the right track.At 03:33 PM 11/7/2008, Nicola O'Byrne wrote:

Hi again Im looking for suggestions to help a client who had a breast reduction6 years ago. She had 6 1/2 lbs of tissue removed ( is that alot?) .Its not something I have alot of experience working with but Imguessing its the same as low supply ...am I right there or is thisgoing to be much harder to increase the supply? What should ourexpectations be? Ok so this mum just had her 2nd baby 2 weeks ago . With her first baby she never produced any milk - so this time shesays shewould be happy to breastfeed 2 or 3 times per day. Only now.. the babyis refusing the breast - sometimes takes up to 40 minutes to latch .Of course, just to confuse the issue , the baby has a tongue tie. Itsnot an option to get this clipped for another month at least ( nobodyavailable and mum not sure she wants to) .She is supplementing with lots of formula , pumping but getting dropsonly . SO the plan is .. try domperidone , increase pump flange size as shehas large nipples, start off feed with shield if baby wont latchwithout , fill shield with milk if baby fights shield, skin to skin asmuch as possible (unfortunately the 2 year old is not coping well withthe new arrival and has started to actually pull her own hair out) sothe mums feels her own stress is affecting the supply too. Ive gone though paced bottle feeding with the mum as she doesnt wantto use as supplementer ( she feels thats one step too far ). Is there anything else to suggest apart from lots of support andencouragement? Thank you in advance for any answers - it helps just to write it downsometimes . Nicola O'Byrnewww.breastfeedingsupport.ie Dublin ,Ireland.

[Guest guest]

Hi ,

goat's rue can be taken in addition to domperidone? I wasn't sure about

that

a

West, IBCLC ha scritto:

Hi, ,

Yes, managing milk supply after reduction surgery doesn't differ much

from general low milk supply issues. You'll just want to do what

you've already recommended: maximize milk removal and consider

galactagogues, goat's rue in particular in addition to domperidone.

Also, be sure to rule out any baby-sided issues and screen for maternal

hormonal issues, as well. Baby taking so long to latch may be a red

flag for tongue problems. Reassure the mom that stress is not

likely to have a significant impact on her supply, but she can try

relaxation measures to help with let down. Also confidence will

build with time.

Quick answers to a complex situation, but hopefully this reassures you

that you're already on the right track.

At 03:33 PM 11/7/2008, Nicola O'Byrne wrote:

Hi again

Im looking for suggestions to help a client who had a breast

reduction

6 years ago. She had 6 1/2 lbs of tissue removed ( is that alot?) .

Its not something I have alot of experience working with but Im

guessing its the same as low supply ...am I right there or is this

going to be much harder to increase the supply? What should our

expectations be?

Ok so this mum just had her 2nd baby 2 weeks ago .

With her first baby she never produced any milk - so this time she

says she

would be happy to breastfeed 2 or 3 times per day. Only now.. the

baby

is refusing the breast - sometimes takes up to 40 minutes to latch .

Of course, just to confuse the issue , the baby has a tongue tie.

Its

not an option to get this clipped for another month at least (

nobody

available and mum not sure she wants to) .

She is supplementing with lots of formula , pumping but getting

drops

only .

SO the plan is .. try domperidone , increase pump flange size as she

has large nipples, start off feed with shield if baby wont latch

without , fill shield with milk if baby fights shield, skin to skin

as

much as possible (unfortunately the 2 year old is not coping well

with

the new arrival and has started to actually pull her own hair out)

so

the mums feels her own stress is affecting the supply too.

Ive gone though paced bottle feeding with the mum as she doesnt want

to use as supplementer ( she feels thats one step too far ).

Is there anything else to suggest apart from lots of support and

encouragement?

Thank you in advance for any answers - it helps just to write it

down

sometimes .

Nicola O'Byrne

www.breastfeedingsupport.ie

Dublin ,Ireland.

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[Guest guest]

yes definitely! i have had many clients do both. they each work quite differently and can be complimentary. the only herb, as i understand it, that cannot be combined with domperdone is shatavari as it's action is quite similar.

Lyla

[sPAM]Re: Breast Reduction - low supply

Hi ,goat's rue can be taken in addition to domperidone? I wasn't sure about thata West, IBCLC ha scritto:

Hi, ,Yes, managing milk supply after reduction surgery doesn't differ much from general low milk supply issues. You'll just want to do what you've already recommended: maximize milk removal and consider galactagogues, goat's rue in particular in addition to domperidone. Also, be sure to rule out any baby-sided issues and screen for maternal hormonal issues, as well. Baby taking so long to latch may be a red flag for tongue problems. Reassure the mom that stress is not likely to have a significant impact on her supply, but she can try relaxation measures to help with let down. Also confidence will build with time.Quick answers to a complex situation, but hopefully this reassures you that you're already on the right track.At 03:33 PM 11/7/2008, Nicola O'Byrne wrote:

Hi again Im looking for suggestions to help a client who had a breast reduction6 years ago. She had 6 1/2 lbs of tissue removed ( is that alot?) .Its not something I have alot of experience working with but Imguessing its the same as low supply ...am I right there or is thisgoing to be much harder to increase the supply? What should ourexpectations be? Ok so this mum just had her 2nd baby 2 weeks ago . With her first baby she never produced any milk - so this time shesays shewould be happy to breastfeed 2 or 3 times per day. Only now.. the babyis refusing the breast - sometimes takes up to 40 minutes to latch .Of course, just to confuse the issue , the baby has a tongue tie. Itsnot an option to get this clipped for another month at least ( nobodyavailable and mum not sure she wants to) .She is supplementing with lots of formula , pumping but getting dropsonly . SO the plan is .. try domperidone , increase pump flange size as shehas large nipples, start off feed with shield if baby wont latchwithout , fill shield with milk if baby fights shield, skin to skin asmuch as possible (unfortunately the 2 year old is not coping well withthe new arrival and has started to actually pull her own hair out) sothe mums feels her own stress is affecting the supply too. Ive gone though paced bottle feeding with the mum as she doesnt wantto use as supplementer ( she feels thats one step too far ). Is there anything else to suggest apart from lots of support andencouragement? Thank you in advance for any answers - it helps just to write it downsometimes . Nicola O'Byrnewww.breastfeedingsupport.ie Dublin ,Ireland.

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[Guest guest]

Thank you so much and Lyla . I will

tell her about goats rue . Its very interesting about the severed ducts too , 

I think that may have been an issue .

I’m off to buy the book .

Thanks again

Nicola

From:

[mailto: ] On Behalf Of Lyla Wolfenstein

Sent: 08 November 2008 06:18

To:

Subject: Re: Breast

Reduction - low supply

yes definitely! i have had many clients do both. they

each work quite differently and can be complimentary. the only

herb, as i understand it, that cannot be combined with domperdone is shatavari

as it's action is quite similar.

Lyla

[sPAM]Re:

Breast Reduction - low supply

Hi ,

goat's rue can be taken in addition to domperidone? I wasn't sure about that

a

West, IBCLC ha scritto:

Hi, ,

Yes, managing milk supply after reduction surgery doesn't differ much from

general low milk supply issues. You'll just want to do what you've

already recommended: maximize milk removal and consider galactagogues,

goat's rue in particular in addition to domperidone. Also, be sure to

rule out any baby-sided issues and screen for maternal hormonal issues, as

well. Baby taking so long to latch may be a red flag for tongue problems.

Reassure the mom that stress is not likely to have a significant impact on her

supply, but she can try relaxation measures to help with let down. Also

confidence will build with time.

Quick answers to a complex situation, but hopefully this reassures you that

you're already on the right track.

At 03:33 PM 11/7/2008, Nicola O'Byrne wrote:

Hi again

Im looking for suggestions to help a client who had a breast reduction

6 years ago. She had 6 1/2 lbs of tissue removed ( is that alot?) .

Its not something I have alot of experience working with but Im

guessing its the same as low supply ...am I right there or is this

going to be much harder to increase the supply? What should our

expectations be?

Ok so this mum just had her 2nd baby 2 weeks ago .

With her first baby she never produced any milk - so this time she

says she

would be happy to breastfeed 2 or 3 times per day. Only now.. the baby

is refusing the breast - sometimes takes up to 40 minutes to latch .

Of course, just to confuse the issue , the baby has a tongue tie. Its

not an option to get this clipped for another month at least ( nobody

available and mum not sure she wants to) .

She is supplementing with lots of formula , pumping but getting drops

only .

SO the plan is .. try domperidone , increase pump flange size as she

has large nipples, start off feed with shield if baby wont latch

without , fill shield with milk if baby fights shield, skin to skin as

much as possible (unfortunately the 2 year old is not coping well with

the new arrival and has started to actually pull her own hair out) so

the mums feels her own stress is affecting the supply too.

Ive gone though paced bottle feeding with the mum as she doesnt want

to use as supplementer ( she feels thats one step too far ).

Is there anything else to suggest apart from lots of support and

encouragement?

Thank you in advance for any answers - it helps just to write it down

sometimes .

Nicola O'Byrne

www.breastfeedingsupport.ie

Dublin ,Ireland.

__________ Informazione NOD32 3596 (20081107) __________

Questo messaggio è stato controllato dal Sistema Antivirus NOD32

http://www.nod32.it

[Guest guest]

We don't have any research to guide us, but many mothers are

doing this and seem to have a better result than with either alone.

In fact, most of the mothers on the BFAR forums are taking herbs in

addition to domperidone.

At 01:12 AM 11/8/2008, giadaeli wrote:

Hi ,

goat's rue can be taken in addition to domperidone? I wasn't sure about

that

a

West, IBCLC ha scritto:

Hi, ,

Yes, managing milk supply after reduction surgery doesn't differ much

from general low milk supply issues. You'll just want to do what

you've already recommended: maximize milk removal and consider

galactagogues, goat's rue in particular in addition to domperidone.

Also, be sure to rule out any baby-sided issues and screen for maternal

hormonal issues, as well. Baby taking so long to latch may be a red

flag for tongue problems. Reassure the mom that stress is not

likely to have a significant impact on her supply, but she can try

relaxation measures to help with let down. Also confidence will

build with time.

Quick answers to a complex situation, but hopefully this reassures you

that you're already on the right track.

At 03:33 PM 11/7/2008, Nicola O'Byrne wrote:

Hi again

Im looking for suggestions to help a client who had a breast

reduction

6 years ago. She had 6 1/2 lbs of tissue removed ( is that alot?) .

Its not something I have alot of experience working with but Im

guessing its the same as low supply ...am I right there or is this

going to be much harder to increase the supply? What should our

expectations be?

Ok so this mum just had her 2nd baby 2 weeks ago .

With her first baby she never produced any milk - so this time she

says she

would be happy to breastfeed 2 or 3 times per day. Only now.. the

baby

is refusing the breast - sometimes takes up to 40 minutes to latch .

Of course, just to confuse the issue , the baby has a tongue tie.

Its

not an option to get this clipped for another month at least (

nobody

available and mum not sure she wants to) .

She is supplementing with lots of formula , pumping but getting

drops

only .

SO the plan is .. try domperidone , increase pump flange size as she

has large nipples, start off feed with shield if baby wont latch

without , fill shield with milk if baby fights shield, skin to skin

as

much as possible (unfortunately the 2 year old is not coping well

with

the new arrival and has started to actually pull her own hair out)

so

the mums feels her own stress is affecting the supply too.

Ive gone though paced bottle feeding with the mum as she doesnt want

to use as supplementer ( she feels thats one step too far ).

Is there anything else to suggest apart from lots of support and

encouragement?

Thank you in advance for any answers - it helps just to write it

down

sometimes .

Nicola O'Byrne

www.breastfeedingsupport.ie

Dublin ,Ireland.

__________ Informazione NOD32 3596 (20081107) __________

Questo messaggio è stato controllato dal Sistema Antivirus NOD32

http://www.nod32.it

[Guest guest]

Lyla, we're not sure about this and have actually backed off

of this recommendation for now until we have more research. Many

mothers are taking shatavari with domperidone and seem to be doing

well.

At 01:17 AM 11/8/2008, Lyla Wolfenstein wrote:

yes definitely! i have had

many clients do both. they each work quite differently and can be

complimentary. the only herb, as i understand it, that cannot be

combined with domperdone is shatavari as it's action is quite

similar.

Lyla

[sPAM]Re: Breast Reduction - low

supply

Hi ,

goat's rue can be taken in addition to domperidone? I wasn't sure

about that

a

West, IBCLC ha scritto:

Hi, ,

Yes, managing milk supply after reduction surgery doesn't differ much

from general low milk supply issues. You'll just want to do what

you've already recommended: maximize milk removal and consider

galactagogues, goat's rue in particular in addition to domperidone.

Also, be sure to rule out any baby-sided issues and screen for maternal

hormonal issues, as well. Baby taking so long to latch may be a red

flag for tongue problems. Reassure the mom that stress is not

likely to have a significant impact on her supply, but she can try

relaxation measures to help with let down. Also confidence will

build with time.

Quick answers to a complex situation, but hopefully this reassures

you that you're already on the right track.

At 03:33 PM 11/7/2008, Nicola O'Byrne wrote:

Hi again

Im looking for suggestions to help a client who had a breast

reduction

6 years ago. She had 6 1/2 lbs of tissue removed ( is that alot?)

..

Its not something I have alot of experience working with but Im

guessing its the same as low supply ...am I right there or is

this

going to be much harder to increase the supply? What should our

expectations be?

Ok so this mum just had her 2nd baby 2 weeks ago .

With her first baby she never produced any milk - so this time

she

says she

would be happy to breastfeed 2 or 3 times per day. Only now.. the

baby

is refusing the breast - sometimes takes up to 40 minutes to latch

..

Of course, just to confuse the issue , the baby has a tongue tie.

Its

not an option to get this clipped for another month at least (

nobody

available and mum not sure she wants to) .

She is supplementing with lots of formula , pumping but getting

drops

only .

SO the plan is .. try domperidone , increase pump flange size as

she

has large nipples, start off feed with shield if baby wont latch

without , fill shield with milk if baby fights shield, skin to skin

as

much as possible (unfortunately the 2 year old is not coping well

with

the new arrival and has started to actually pull her own hair out)

so

the mums feels her own stress is affecting the supply too.

Ive gone though paced bottle feeding with the mum as she doesnt

want

to use as supplementer ( she feels thats one step too far ).

Is there anything else to suggest apart from lots of support and

encouragement?

Thank you in advance for any answers - it helps just to write it

down

sometimes .

Nicola O'Byrne

www.breastfeedingsupport.ie

Dublin ,Ireland.

__________ Informazione NOD32 3596 (20081107) __________

Questo messaggio è stato controllato dal Sistema Antivirus NOD32

http://www.nod32.it

[Guest guest]

wow - great to know! thanks diana!!

[sPAM]Re: Breast Reduction - low supply

Hi ,

goat's rue can be taken in addition to domperidone? I wasn't sure about that

a

West, IBCLC ha scritto:

Hi, ,

Yes, managing milk supply after reduction surgery doesn't differ much from general low milk supply issues. You'll just want to do what you've already recommended: maximize milk removal and consider galactagogues, goat's rue in particular in addition to domperidone. Also, be sure to rule out any baby-sided issues and screen for maternal hormonal issues, as well. Baby taking so long to latch may be a red flag for tongue problems. Reassure the mom that stress is not likely to have a significant impact on her supply, but she can try relaxation measures to help with let down. Also confidence will build with time.

Quick answers to a complex situation, but hopefully this reassures you that you're already on the right track.

At 03:33 PM 11/7/2008, Nicola O'Byrne wrote:

Hi again

Im looking for suggestions to help a client who had a breast reduction

6 years ago. She had 6 1/2 lbs of tissue removed ( is that alot?) .

Its not something I have alot of experience working with but Im

guessing its the same as low supply ...am I right there or is this

going to be much harder to increase the supply? What should our

expectations be?

Ok so this mum just had her 2nd baby 2 weeks ago .

With her first baby she never produced any milk - so this time she

says she

would be happy to breastfeed 2 or 3 times per day. Only now.. the baby

is refusing the breast - sometimes takes up to 40 minutes to latch .

Of course, just to confuse the issue , the baby has a tongue tie. Its

not an option to get this clipped for another month at least ( nobody

available and mum not sure she wants to) .

She is supplementing with lots of formula , pumping but getting drops

only .

SO the plan is .. try domperidone , increase pump flange size as she

has large nipples, start off feed with shield if baby wont latch

without , fill shield with milk if baby fights shield, skin to skin as

much as possible (unfortunately the 2 year old is not coping well with

the new arrival and has started to actually pull her own hair out) so

the mums feels her own stress is affecting the supply too.

Ive gone though paced bottle feeding with the mum as she doesnt want

to use as supplementer ( she feels thats one step too far ).

Is there anything else to suggest apart from lots of support and

encouragement?

Thank you in advance for any answers - it helps just to write it down

sometimes .

Nicola O'Byrne

www.breastfeedingsupport.ie

Dublin ,Ireland.

__________ Informazione NOD32 3596 (20081107) __________

Questo messaggio è stato controllato dal Sistema Antivirus NOD32

http://www.nod32.it