I have a client with a 10 week old baby who is feeding hourly by day and
2 hourly by night.  Baby has been doing this for 5 weeks, I was called 3
days ago.  Mum breastfed her last baby for only 3 weeks due to baby
needing hospitalization!  This baby is gaining weight at 300 grams per
week.  He feeds 4 mins each breast, refuses any more, she expresses,
gets 40 mls out in total then comps him with that.  She is using an
electic pump 3hourly by day and once at night.  Unsure of letdown, no
sensation, leaking, spraying of milk if baby comes off.  Relaxation
techniques advised as well as all the normal advice to increase milk
supply.  Baby is positioned and attatched well, no problems except for a
receeding chin, but mum coping well with his attatchment despite this.
When baby comes off after feeds, he is happy then cries after an hour.
She is feeding him as a last resort then, after trying other ways to
occupy him.  Won't take a dummy.  Can any one offer any other
suggestions, what do you think of the weight gain?  She does smoke, 10 a
day, ?? inhibiting letdown.  Poor mum has been told by doctor and child
health nurse to put the baby on a bottle.  She was also given a mexican
hat by the nurse, needless to say she thought it was a wierd looking
thing so stopped using it!!
I'd appreciate some comments.
Val in Busselton, West Australia
RN RM IBCLC