Circumstances this time are totally different to last time. For a start she was suppressing lactation last time, where as this time she would be establishing lactation. Last time she probably had a large blood loss and was physically and mentally in a much poorer state of immune defense than she will be this time. And last time it sounds like she was quite poorly managed, whereas I hope this time she won't be.

Talk to her about all the factors that predispose to mastitis and how to recognise and treat them early - this is clearly explained in our BreastEd course BE07 or any of your quality breastfeeding texts.

Also I think they both probably need to have a big discussion about what breastfeeding and breastmilk will do for their child ... or rather the problems their child, and the mother, are likely to encounter from not breastfeeding. It's understandable for husband's not to want to see their wives go through pain, but he doesn't yet know how painful it would be to sit beside the cot and watch his baby in hospital with pneumonia, or gastroenteritis which are just the mild disadvantages of infant formula - to say nothing of the greatly increased risk of the child acquiring diabetes, leukemia, etc and the guaranteed loss of IQ points that all infant formula-fed children have.

Breastfeeding isn't a 'walk in the park' for some women - but it is worth it if it is even remotely possible.

thankyou for your reply Denise, I was wondering if you had any information re mastitis occuring so early in a pregnancy. I was quite surprised to hear that the woman had developed mastitis on 3 occasions at 13 weeks gestation. Unfortunately this woman does not want to talk to an LC so I am communicating via her childbirth educator. We have already tried to convey the above info as outlined by you. I also suggested she try adding lecithin to her diet, multivitamin and ensuring a healthy diet. This woman sounds very conflicted.

It is unusual for a woman to progress into lactogenesis II after a miscarriage at 13 weeks. That doesn't usually occur until a little later in the pregnancy (could anyone else tell of their experience of this please).
But yes, progressing to lactogenesis II (now known as secretory activation) is normal for any pregnancy loss from around the middle of pregnancy, after lactogenesis I (secretory differentiation) has occurred.

Kathy I think there are a lot of other things going on with the mother you are hearing about - and perhaps focusing on whether she will breastfeed or not is simply a way of controlling the only thing she feels she can control at this stage. Circumstances are sooo different this time that I'm surprised she's even linking them. Maybe she just doesn't want to breastfeed and is looking for a 'plausible' reason as to why she won't.