Hypogalactia Treated with Hand Expression and Translactation without the Use of Galactagogues
ABSTRACT This case study demonstrates the possibility of treating hypogalactia without using galactagogues. The focus is a female child who, in her first 54 days of life, had a weight gain of only 610 g, with a daily average of 11 g. The child suffered from improper latch-on, insufficient sucking, and consequent excessive drowsiness. During the first clinical visit by the mother, hand expression produced only 5 mL of breast milk. Mother and daughter were assisted daily with the hand expression and translactation method, without the use of any other milk, feeding bottles, or galactagogues. After 2 months and 6 days of assistance, the infant gained 1800 g. The child was exclusively breastfed for 6 months, after which she received complementary foods and continued breastfeeding until her 27th month. She crawled at the age of 7 months and walked when she was 1 year old. She is currently 4 and very healthy.
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ABSTRACT: The aim of this study was to use ultrasound imaging to re-investigate the anatomy of the lactating breast. The breasts of 21 fully lactating women (1-6 months post partum) were scanned using an ACUSON XP10 (5-10 MHz linear array probe). The number of main ducts was measured, ductal morphology was determined, and the distribution of glandular and adipose tissue was recorded. Milk ducts appeared as hypoechoic tubular structures with echogenic walls that often contained echoes. Ducts were easily compressed and did not display typical sinuses. All ducts branched within the areolar radius, the first branch occurring 8.0 +/- 5.5 mm from the nipple. Duct diameter was 1.9 +/- 0.6 mm, 2.0 +/- 90.7 mm and the number of main ducts was 9.6 +/- 2.9, 9.2 +/- 2.9, for left and right breast, respectively. Milk ducts are superficial, easily compressible and echoes within the duct represent fat globules in breastmilk. The low number and size of the ducts, the rapid branching under the areola and the absence of sinuses suggest that ducts transport breastmilk, rather than store it. The distribution of adipose and glandular tissue showed wide variation between women but not between breasts within women. The proportion of glandular and fat tissue and the number and size of ducts were not related to milk production. This study highlights inconsistencies in anatomical literature that impact on breast physiology, breastfeeding management and ultrasound assessment.Journal of Anatomy 07/2005; 206(6):525-34. DOI:10.1111/j.1469-7580.2005.00417.x · 2.23 Impact Factor
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ABSTRACT: Focus group interviews were used to explore the breastfeeding attitudes and experiences of a group of low-income Scottish women who were breastfeeding in an environment where bottle-feeding was the cultural norm. The majority of women interviewed had no prior exposure to breastfeeding and received little or no support or advice for breastfeeding from family or friends. All women were participants in a breastfeeding peer-support project, and for most the peer volunteers represented their only source of support and guidance, outside of that provided by health professionals. Women often went to great lengths to avoid having to breastfeed in public, and the majority preferred to breastfeed away from the public gaze. Despite reported increases in breastfeeding rates, bottle-feeding remains the cultural norm in the more deprived areas of Glasgow. Those women who do breastfeed in these areas demonstrate a high level of commitment to breastfeeding that sets them apart from their social peers.Journal of Human Lactation 09/2003; 19(3):270-7. DOI:10.1177/0890334403255225 · 1.98 Impact Factor
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ABSTRACT: Health experts worldwide recognize breastmilk as the superior infant food. Recommendations from the American Academy of Pediatrics and the World Health Organization (WHO) identify exclusive breastfeeding for the first half-year of life and continuation of breastfeeding into toddlerhood as offering maximum protection from illness, providing a substrate for immunological protection. Data from developed countries identify increasing morbidity and mortality rates for infants who have never received breastmilk in life and demonstrate that infants benefit from exclusive breastfeeding, especially, in areas of severe poverty. Preterm infants, most at risk for morbidity and mortality in developing countries, are identified as needing their own mother's milk for survival. Exclusive feeding of own mothers' milk (OMM) is associated with improved infant survival; however, inadequate maternal milk volume (MMV) often necessitates adding artificial feedings or exogenous substances to OMM. The objective of this study was to compare mean daily MMV for mothers of premature or sick infants in special care nurseries (SCN) using one of three methods of OMM expression: electric breast pump, non-electric pedal breast pump, and hand (manual) expression. We studied 65 mothers whose infants were cared for in two SCN in Africa (Kenya and Nigeria) and were unable to feed directly at the breast. In this randomized trial, mothers were randomly assigned to one of three milk expression groups at birth. MMV, the dependent variable, was measured for an average of 8.7 days. MMV for the electric and pedal pump and hand milk expression was 578 +/- 228 ml (n = 22), 463 +/- 302 ml (n = 24) and 323 +/- 199 ml (n = 19), respectively. Data were evaluated using a one-way ANOVA (p = 0.014). The Tukey revealed significant differences (p < 0.01) between electric breast pump expression and hand expression but not between the electric and pedal pump or the pedal pump and hand expression. Findings revealed greater MMV with electric breast pumps than hand-expression for mothers of infants in African nurseries. This data has important implications for international policy if exclusive OMM feeding is to be achieved for the vulnerable infant. Funded by West Virginia University Department of Research and Graduate Studies HSC Grant # 2U023U; Non-monetary donations of breast pumps and breast pump kits were made by Medela (Medela, Inc., McHenry, IL, USA).Journal of Tropical Pediatrics 04/2007; 53(2):125-30. DOI:10.1093/tropej/fml066 · 0.86 Impact Factor