I've worked with post-gastric bypass moms in cooperation with my sister 
Carole, who is an RD specializing in clinical nutrition and eating 
disorders. Carole recommends that each bite mom eats packs a nutritional 
punch - high protein and high nutritious fats, in order to cover mom's 
caloric and vitamin needs. Fat soluble vitamins are particularly an 
issue for moms with the Roux-en-y procedure. Combining optimum nutrition 
with a good assessment of the breastfeeding or pumping management and 
lactation intervention would likely be more valuable than taking up her 
small stomach capacity with herbs.

Is her baby only feeding qid? If so, encourage her to feed him very 
frequently, handle him gently (lower lights, skin to skin, minimal 
jostling, turn off or down the phone ringers, stereo, tv, etc- all are 
evidence based ways to help late preterm infants feed better), work on 
optimal attachment to the breast, consider a nipple shield if he can't 
stay on the breast and transfer milk, etc. Consider supplementing at the 
breast if his cardiorespiratory capacity is up to it. If she's pumping 
frequently and it's not working for her, have her try a different pump 
and/or manual expression. I'd imagine more of the issue is the baby's 
immaturity than the mom's gastric bypass. Have you seen them in person?

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com

On 7/2/2012 11:02 AM, Angela Brekken wrote:
> PTP:  I am wondering if someone may be able to share some tips for a mom
> with gastric bypass 6 years ago w/a 34w gestation infant that is now 8
> days old and 2oz below birthweight. Was able to receive donor milk while
> in the NICU but supplementing w/50ml formula qid now that she is home.
> Goal is to exclusively breastfeed by next office visit in 1mo.
> Discussed some benefits with barley, oatmeal, alfalfa, fennel already.
> Fenugreek mentioned.  Discussed a minimum of 1800 kcals needed/day for
> breastfeeding.  Any other pointers?  Thank you for your help!
>
>   
>
> Angie
>
>   
>
>
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