update on the mom who suffered a stroke:  She is out of the hospital now and
doing well.  going to rehab 3 days per week.  the baby did not nurse at the
breast for about 4 weeks while she was in the hospital recovering . she had
no stimulation to the breast for about 7 days while she was in the ICU
immediately after the stroke.  at 7 days I was contacted to get her a pump.
 she pumped for 3 weeks faithfully in the rehab hospital about 5 times every
24 hours.(  I knew this was not ideal but with the rehab schedule she had it
was all she could manage)  since she went home 1 week ago the baby will latch
on and suck.  I observed him today and he is latched on well and will stay on
for as long as mom will leave him on.  We started with the SNS today to help
mom eliminate the step of having to bottle feed.  mom was not putting baby to
breast this first week at every feeding because " he wasn't getting anything"
she also has grown tired of pumping.( can't blame her there). Here is the
thing:  when I got her started pumping in the hospital she was only getting
drops of breastmilk and she is still only getting drops when she pumps.
 while I observed a good latch today there is no swallowing going on.  Mom
now has instructions to put baby to breast as often as possible.  to use SNS
for as many feeding s as possible to encourage baby to suck and swallow and
not just comfort nurse.  and to pump after feedings .    Here are My
questions to the experts: 1.  what else can she do to stimulate milk
production? 2. would Reglan be a good suggestion at this point?( didnt try it
before due to side effects of depression) 3. If baby will suckle how long
should it take for production to return.  Her current meds are coumadin and
Lopressor  (her pediatritian approved both ok for baby)   I have given mom
many positive strokes for her wonderful mothering of this baby.  I have told
her what an inspiration she is to me in light of all the women I see quit due
to simple discomfort.  and I have discussed the possibility of her full milk
supply never returning but that breastfeeding is not just about milk
 etc.....  Any suggestions or comments are welcome.  This mom has been
through alot.  Stroke at 1 month pp this time, pacemaker and valve
replacement in 1995.  Did not bf 4 year old because she was told she couldn't
due to meds she was then on, but told me " I found out I could nurse this
baby and so I did"  From her history bf was going well before the stroke.
 This mom is married and has family support although I am non sure about dad.
 Low income family but has health insurance through her state job.  Now I am
trying to get her insurance to cover my visits and all the needed supplies!!!
  I got the Doctor at the rehab hospital to write orders for theese after
about 3 calls to his office and 2 notes on her chart!!   I am sure it is the
first time he has ever written an order for the HANDS FREE PUMPING BRA AND
KIT.  hopefully not the last.