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Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 10 Aug 1999 14:48:06 EDT
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I am a hospital based lactation consultant, and I have been working with a
35-year-old mother who has been trying to increase her milk supply.  I had
worked with this mother 3 1/2  years ago because of a failure to thrive
situation when her first child was six weeks of age.  At that time, the
mother had experienced a difficult delivery (shoulder dystocia) with a
postpartum hemorrhage.  She used a nursing supplementer and took fenugreek
during the 9 months she breastfed.  This new baby was a vacuum extraction
birth.  The couplet was seen on an outpatient basis when the baby was four
days old.  The mother had sore nipples, was engorged and the baby had a
disorganized suck.  Very little, if any, transfer was taking place when the
infant was placed at breast.  Only 4 cc. of colostrum was expressed when the
mother's breasts were pumped.  The baby was jaundiced, and the pediatrician
ordered phototherapy and an OT consult.  The mother rented a hospital grade
electric pump and was taught how to finger feed the baby.  The baby's suck
improved, and the baby now nurses at breast with the mother using a nursing
supplementer.  To increase her milk supply, the mother has done some
"insurance" pumping after feedings, used breast compression while nursing,
eaten oatmeal, and she is taking fenugreek and blessed thistle.  She is aware
of Reglan but prefers not to take it because of its possible side effects.
The mother's current prolactin level is 47.7 and her thyroid level is 1.5.
Today, at three weeks, the maximum amount of breastmilk obtained at a feeding
was 59cc., but the average intake of breastmilk at a feeding is 37cc.  I am
looking to you Lactnetters for your wisdom and words of encouragement.  What
other recommendations would you make to this mother?  Considering this
mother's history, is it still possible that her milk supply could increase to
the point where her baby won't require supplementation?  Any suggestions will
be most appreciated.  Lois Warrington, RN,BS,IBCLC

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