tubular hypoplastic breasts? WAS puffy areolas after birth = probably low supply?? - Mothering Forums
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#1 of 25 Old 01-09-2008, 12:27 AM - Thread Starter
 
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My friend just gave birth to a baby in a hospital after a very long, difficult labour (transported from home). Her midwife (who is also an LC) took me aside and hinted that I should start pumping (talked about drugs for increasing supply and the milk bank) as my friend's areolas are very puffy and that indicates likely problems with low supply. Is this true? She didn't mention it to my friend as she doesn't want to worry her prematurely.

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#2 of 25 Old 01-09-2008, 12:51 AM
 
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I have never heard of that before at all. How often is she getting baby tot he breast? Is baby rooming in with her? Is baby getting any artificial nipples(bottles or pacifiers)?

Here is a great read on what to do for a successful start, maybe you could go over it and just talk to her about it? Or if she is open to it, you could print it off for her?

Successful start tips:
http://www.kellymom.com/bf/start/pre...eparation.html

Breastfeeding 101:
http://www.obgyn.net/women/women.asp...astfeeding-101

Basics of the early weeks:
http://www.kellymom.com/bf/start/basics/index.html

Now if she is engorged and she is having trouble getting baby latched on here is a great trick:
http://www.kellymom.com/bf/concerns/...cotterman.html
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#3 of 25 Old 01-09-2008, 01:28 AM
 
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Puffy isn't a great description for me...but I know that sore/scabbed/bleeding nipples can definitely benefit from a pump - because you don't have to worry about bad latch, and keep your supply up while still giving the baby BM.

I think puffy nipples = low supply is a pretty weird relationship. How can you tell supply from the shape of the nipples? I can see puffy nipples = some kind of hormone imbalance (ie looong labour?) and then maybe longer time for milk to 'come in'....that makes a bit of sense but I just made it up.

Also, I think it is too early to tell if there will be low supply b/c doesn't supply come with demand?

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#4 of 25 Old 01-09-2008, 01:43 AM
 
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Ksenia, in regards to your question about a pump, you can generally rent hospital-grade by the day or week from most baby supply stores or pharmacies.

If it is a longer-term situation, you can buy hospital grade, but I liked my medela, too. And it didn't feel like it was pulling my nipples off.

Is it you who is possibly pumping, or her? If it's you, I'd go for a medela or something because I know that you tend to over rather than undersupply. Pumping is a skill, but I think that an established supply (and a relaxed attitude) makes it easier.

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#5 of 25 Old 01-09-2008, 02:13 AM - Thread Starter
 
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studentmama, my friend is relatively informed about breastfeeding. She just gave birth today and the baby is rooming in...no artificial nipples or factors that would interfere with breastfeeding. They were initiating BF when I left.

widemouthedfrog, the idea is that I would be pumping to supplement her presumed low supply (that's what the LC was advising indirectly and without my friend's knowledge). I'm pretty sure I can produce milk, though I had a lot of problems trying once with an Avent hand pump so I am hoping that a "hospital grade" pump will be more effective.

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#6 of 25 Old 01-09-2008, 02:23 AM - Thread Starter
 
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I think I have figured out what the LC is worried about. She is probably concerned that my friend has tubular hypoplastic breasts with insufficient glandular tissue (scroll down). I wonder how common this is .

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#7 of 25 Old 01-09-2008, 02:41 AM - Thread Starter
 
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Just found this thread on insufficient breast tissue here at Mothering.

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#8 of 25 Old 01-09-2008, 02:47 AM
 
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Originally Posted by Ksenia View Post
I think I have figured out what the LC is worried about. She is probably concerned that my friend has tubular hypoplastic breasts with insufficient glandular tissue (scroll down). I wonder how common this is .
Hmm, well these are the recs from the site you linked,
"have an unmedicated birth if possible, and put the baby to the breast right after birth
nurse often and on cue
start to pump about three days after birth
try the herbs fenugreek and blessed thistle or the drug domperidone
breast compression technique to stimulate more letdowns
Correct underlying metabolic or hormonal issues (PCOS, hypothyroidism)"

I am wondering if the midwife might be jumping the gun a bit? I am glad she didn't mention it to the mama.
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#9 of 25 Old 01-09-2008, 02:58 AM
 
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If you look at women who can't breastfeed at all, it's pretty common. In general, it's pretty rare.

Does she have more nipple than breast? Small breasts is no the issue, but rather all nipple. As if the nipple belonged on a DD, but lived on a ribcage.

How much milk do you have? Do you have enough for one day for a newborn - 15 ounces or so, at least? If so, I wouldn't worry about it until there is a documented problem. I think it will all work fine.

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#10 of 25 Old 01-09-2008, 03:05 AM - Thread Starter
 
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Originally Posted by studentmama View Post
I am wondering if the midwife might be jumping the gun a bit? I am glad she didn't mention it to the mama.
In the MDC thread that I posted above, most women had to supplement with formula. I think the MW is trying to provide an alternative to formula (my expressed breastmilk) if supplementation is needed :.
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Originally Posted by Apricot View Post
Does she have more nipple than breast?
They do look a bit like one of the photos.
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Originally Posted by Apricot View Post
How much milk do you have?
: I have no idea. I am currently breastfeeding both of my children and I've been breastfeeding continuously for over 4 years. If I skip a feeding of dd I do feel let-downs and have leaking. In the past I had oversupply problems, but things seem to be in balance currently.

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#11 of 25 Old 01-09-2008, 03:08 AM
 
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There is a small study here which tells about tubular breasts, a table of characteristics, AND possible outcomes regarding milk production.

I have Type II tubular breasts, and am able to produce about 1/2 of what my DD needs, and that's with every trick in the book.

Anyway, obviously, this sample size for this study is very small, so, it's not exactly the best in the world, but it's the only one I've found so far. The bad news is that in the first week pp, women with tubular breasts have very slim chances of producing even half of what their baby needs. However, the GOOD news is by the end of the first month, by doing all the "tricks", about a third of those with type II are able to produce 100% of what their baby needs. Outcomes for type III and IV are not as positive, but ALL women were able to produce SOME milk for their babies.

I wish your friend the best of luck.
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#12 of 25 Old 01-09-2008, 03:23 AM - Thread Starter
 
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for the link katheek!

Quote:
Eighty-five percent of these mothers [identified as having hypoplasia within the first 5 days postpartum] produced 50% or less of the milk necessary for their newborns during the first week post partum
It looks like there is a high chance of my friend having some challenges ahead .

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#13 of 25 Old 01-09-2008, 04:38 PM
 
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Oh hugs, that sounds challenging.

You are such a wonderful friend. You really are a gem.

Kate: fumbling through the best years with W, L, F & V...newest arrival coming Jan '11
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#14 of 25 Old 01-09-2008, 04:56 PM
 
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I was diagnosed with breast hypoplasia after the birth of my second. If your friend does have this (and I think it's really too early to know) she'll still produce some milk. And any milk that she can provide to her baby is wonderful and she should be encouraged to continue breastfeeding. I found a SNS to be a wonderful tool. It can be quite shocking to find out that you can't meet your babies needs, it sounds like she can count on you to support her through that difficult time. Honestly, it still bothers me sometimes. I managed to successfully keep my third child at the breast by using an SNS and he's still enjoying what little milk I can provide him at 4yo!

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My heartfelt thanks to all those that have donated milk to others; you are amazing
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#15 of 25 Old 01-10-2008, 03:04 PM
 
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I wanted to mention that with my own "insufficient glandular tissue" (though not officially diagnosed as hypoplastic), although I took domperidone and fenugreek and assorted other herbals, the one thing that really seemed to make a difference for me in terms of actually increasing breast tissue was the herbal Goat's Rue. I took alot of it. And I produced about 50% of DD2's needs.. stuck with the SNS for about 13 months.

http://www.kellymom.com/herbal/milks...bal-rem_f.html

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#16 of 25 Old 01-10-2008, 04:07 PM
 
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Sometimes the breasts can become edematous bc of too much IV fluid. Thats where reverse pressure softening can help. Maybe thats what the MW meant?
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#17 of 25 Old 01-10-2008, 09:05 PM - Thread Starter
 
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Originally Posted by Breastfeeding Insomniac View Post
Sometimes the breasts can become edematous bc of too much IV fluid. Thats where reverse pressure softening can help. Maybe thats what the MW meant?
No, I confirmed with her that she believes that my friend has tubular hypoplastic breasts and that it's very likely that she'll have supply issues.

for all the info.

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#18 of 25 Old 01-11-2008, 08:36 PM
 
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Im already showing puffy nips now and I have IGT

I am so bummed. Im due in May and I am praying to nurse this one and not just pump

Good Luck to your friend

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#19 of 25 Old 01-12-2008, 07:16 AM
 
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has your friend had any milk come in yet?

:fingersX:

while it's certainly not the end of the world to have to supplement in some fashion, life will certainly be easier if this turns out to be a false alarm!!

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#20 of 25 Old 01-12-2008, 09:47 AM
 
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nak My best friend has tubular breasts. Her mother has them also and had no milk supply. She just assumed her mother hadn't really tried to breastfeed. My friend tried everything... drinking tons of water, medications, pumping, etc. I helped her with latching correctly, positioning, etc.. Babies gained no weight, started spitting up blood... realized they were getting blood from her and that's it. She felt she "failed" with her first. Determined to do it again with second, and same thing happened. I realize that is all an extreme case, but it was the breast shape and reduced tissue. When her 3rd was born, she nursed him for the first few days in case there was any colostrum but no signs of any milk. She had no signs of engorgement after stopping breastfeeding either.

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nak My best friend has tubular breasts. Her mother has them also and had no milk supply. She just assumed her mother hadn't really tried to breastfeed. My friend tried everything... drinking tons of water, medications, pumping, etc. I helped her with latching correctly, positioning, etc.. Babies gained no weight, started spitting up blood... realized they were getting blood from her and that's it. She felt she "failed" with her first. Determined to do it again with second, and same thing happened. I realize that is all an extreme case, but it was the breast shape and reduced tissue. When her 3rd was born, she nursed him for the first few days in case there was any colostrum but no signs of any milk. She had no signs of engorgement after stopping breastfeeding either.
Almost the same story happened to my friend. She was so bummed. It was very sad. She ended up ff for the remainder of her time and children.
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#22 of 25 Old 01-12-2008, 03:48 PM - Thread Starter
 
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has your friend had any milk come in yet?
seems like there's some coming in today!

now hoping for adequate supply.

baby had his frenulum clipped yesterday and that's helped a LOT.

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#23 of 25 Old 01-12-2008, 07:14 PM
 
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Sweet! I'm so happy for your friend.

If I may, can I suggest she rent a hosp. grade pump (for the first 8 weeks, at least? - if she does WIC, they'll give her one for free, and paying out of pocket isn't very expensive, either), pump after each feeding (even if it's only for 5 minutes - tell her it's better to pump more often, even if it's for less time...ie. 10 minutes every hour vs. 30 minutes every three), pump in the early morning if she can handle the sleep dep. (I swear I basically slept at the pump for 8 months), take lots of fenugreek, oatmeal, goat's rue, etc. Even if she can't provide ALL of her DC's needs, she may be able to provide a significant amount. I swear that the 1/3-1/2 (depending on growth spurts) that I gave DD kept her ridiculously healthy.
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#24 of 25 Old 01-12-2008, 07:43 PM - Thread Starter
 
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Well, the latest is that her MW told me that I don't have to pump :. For now it looks like the milk is coming in OK and the baby is having breastmilk poops . Once the MW has discussed with her the issue of her potentially having this problem, I can relay your advice.

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#25 of 25 Old 01-12-2008, 09:54 PM
 
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Quote:
Originally Posted by Ksenia View Post
Well, the latest is that her MW told me that I don't have to pump :. For now it looks like the milk is coming in OK and the baby is having breastmilk poops . Once the MW has discussed with her the issue of her potentially having this problem, I can relay your advice.
This is awesome! One of the biggest factors in ensuring a good suppply for the duration of nursing is the first six weeks. So a very frequent nursing baby is a very good thing for mamas supply. Good luck to your friend, she's very lucky to have such great support!
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