Well you will have to discuss with mom that there is no one right way
to proceed. Certainly she is off to a good start. The 5% wt loss is
VERY REASSURING to me, if the baby has been exclusively bf for sure. I
follow many babies and note wt loss at d/c and at followup etc. The
ones with real problems typically have a larger wt loss, but you MUST
DO early and frequent followup. I would actually recommend wt checks
forever, during the whole of lactation. The timing of these wt checks
would have to be individualized, but seeing the history, I would not
want to find out in 4wks that we have lost ground. So maybe a drop in
for support and see how they are doing weekly at first, then
2-weekly???
As far as what to do, the clicking might be a latch issue. I have seen
many BFAR situations where the scar tissue at the nipple-areolar
complex causes the nipple or areola to "pucker up." I think the less
gadgets used the better, however, a nipple shield MIGHT help the baby
get a better latch.
I think a lactation aid is the closest to regular bf, so I would be
suggesting that -- if needed at any point. I would hate to recommend
pumping if bf is going well so far, but....ensuring good emptying of
the breast in the early weeks (first month maybe) would certainly help
milk production. I would likely suggest something like More Milk Plus
or possibly ask an herbalist for a personalized mixture for this mom.
PCOS might be an issue underlying some of this. So that might come
into play with an herbal concoction for this mom. Domperidone could be
added if needed.
Laurie Wheeler RN MN IBCLC
Mississippi USA

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome