A few lines of thought here to add for your consideration:

 

*	Did the mom start taking hormonal birth control? If started after 6
weeks it could have made the milk production slow. In my area docs are
prescribing the Nuvaring and the Nexplanon and saying they won't affect milk
production but they do.

Could mom be pregnant?

*	Any other medications, herbs or vitamins the mother is taking?
*	Any medical conditions in the mother - PCOS, diabetic, hypothyroid,
etc.? 

 

*	Was there oversupply at the beginning? Sometimes if there is a
breastfeeding problem that is inherent the baby will coast on the milk
production, but as the supply slows due to shift from endocrine control to
baby driven the weight falters. Using a nipple shield in the beginning is a
red flag for this kind of thing.  

Did you check for tongue tie, cleft, and stridor with swallowing
difficulties? I had a 4 month old come in for a first visit this week who
faltered this way. Observed on the breast it 'looked ok'. Observed on bottle
feeding and he had a terrible suck was slurping all over the place and
bottle feeding taking 30 minutes or more still at this age. Suck assessment
and he was chewing and compressing but not sucking. Oddly enough, mom had no
nipple pain throughout.  Had a tongue and lip tie release 2 days ago and
feeding better immediately on both breast and bottle.

 

*	Is mom working now and baby getting bottles at all? Sometimes they
don't want to feed when mom is away and don't eat enough and then sleep too
much overnight to make up for low day feedings. This especially happens with
very attentive parents when the baby is so secure and cared for that they
don't fuss and go about happily starving. 

 

*	Regardless of the cause of infant faltering, the milk supply is
definitely very low now so I would immediately implement a plan to increase
milk production.

 

*	A baby who has been receiving inadequate calories this long can also
become very disorganized with sucking. Needs a good few days of lots of
supplement, prefer as much breast milk as can be obtained. Might need some
formula too. Increased gradually so that the kiddo is not spitting it all
up. Once gaining weight suck can improve. 

 

Judy Gutowski, BA, IBCLC

"Pray as though everything depended on God. Work as though everything
depended on you." -Saint Augustine

 

 

 


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