Request for Question Clarification by
vitalmed-ga
on
02 Jan 2003 15:27 PST
Hello mollyfisher,
This is an interesting subject and has received increasing attention
in the medical and popular literature, particular the latter. I want
in the meantime to share with you some information and sources that I
have garnered from each perspective and to let you know that I expect
to follow-up very shortly with a more definitive answer upon checking
the appropriate texts.
Cindy Duff, R.N.C., B.S.N., I.B.C.L.C., is a lactation consultant for
Bronson Methodist Hospital, writes at
http://www.glfamily.com/html/mj-01/mj-01-lactation.html, that the
defintive indicator of sufficiency of lactation (milk production) in
the early neonatal period is infant weight gain.
She notes, "While extremely rare, some women may have true
insufficient milk supply as a function of a number of problems, one of
which is insufficient glandular tissue." Other causes of insufficient
milk supply are listed there as well.
A physician by the name of Marianne Neifert, MD and colleagues were
the first, or among the first to describe the condition in the journal
Pediatrics:
Neifert MR, Seacat JM, Jobe WE. "Lactation failure due to insufficient
glandular development of the breast". Pediatrics 1985 Nov;76(5):823-8
"Most problems," they write, "are related to insufficient knowledge,
inappropriate routines, and lack of confidence and are easily managed
or prevented by prenatal education, anticipatory guidance, and
adequate support."
As in all medical diagnoses, the primary criteria to consider is
history (the experience of the patient). They write, "Supportive
history for insufficient glandular tissue within the breast include:
absence of typical breast changes with pregnancy and failure of
postpartum breast engorgement to occur..."
The next step in diagnosis is the patient's symptoms (what the patient
feels) and signs (what the clinician detects). Neifert and colleagues
wrote that associated signs may include a unilateral underdeveloped
breast in and palpable patchy areas of glandular tissue.
The third step in diagnosis, if and when called for is clinical or
laboratory testing. An exam called breast diaphanography that is done
by shining a bright light through the breast can substantiate the
diagnosis.
Dr. Neifert is or has been affiliated with the HealthONE Alliance
Lactation Program, Rose Medical Center, Denver, Colorado and the
University of Colorado School of Medicine. HealthOne's website is
http://www.health1.org/lactation.asp
She is described as being "widely known as "Dr. Mom," having been the
founding board member of the Academy of Breastfeeding Medicine and
author of many books and articles on breastfeeding and parenting. Dr.
Neifert is a board-certified pediatrician, lactation expert, and
serves on the Health Advisory Board of the La Leche League."
She has written a book called, "Dr. Mom's Guide to Breastfeeding"
(Plume, 1998).
Another site that may be of help in terms of information is
http://www.ips-uaap.org/newsIndexDetail.asp?articleId=53.
I shall repost this as answer with any further information I obtain
shortly.
I hope it is helpful and that both mother and baby will be happly,
healthy, and thriving.
vitalmed-ga
