> Thank you so much Margaret,
> (I had to copy and resend this message)

> I had a copy of that book but can’t seem to find it. I wanted to wait for the new edition before buying a new one.
> 
> Yesterday at the consult the baby transferred 12cc’s which is way better than 0 first week, and 4 (2nd) week. When I first went they were using a nipple shield with a feeding tube inside it from hospital. It was very cumbersome and the baby wasn’t really latching and the baby was hungry and refusing the  breast so, I had them focus on feeding, and milk removal any way possible, and putting baby to breast only if they both wanted. I showed them paced bottle feeding and finger feeding and gave them the choice.
> At second visit, baby was gaining, We tried the "cherry" nipple shield put baby to breast after  some supplement. Baby latched much better with that shield, and transferred 4cc’s. One issue was baby keeping tongue up in a way that blocked the breast. I gave her a few tongue exercises which they’ve been doing.. Mom has been putting baby to breast 4x/day with shield, but because the supplementer had been so cumbersome before, was reluctant to use it. 
> This visit, after initial breast feeding,I encouraged mom to put baby back to breast as he was still hungry. I encouraged her to just slip the homemade supplementer in and it worked well. She also was able to latch him directly to the breast without the shield, so I am encouraging that. I tend to give families a menu of choices , because it can be so overwhelming especially after a C-section. Power pumping was in the menu and she is doing it 10 minutes on and 10 off daily and didn’t report it being more difficult than anything else.   
> She is doing hands on pumping but as her breasts are not large she can mainly massage the axilla area without disturbing the pump flange.
> While mom is actively looking for solutions she is also asking when do you call it quits. I answered that everyone has to find their own level of success even tho it’s going slow the baby is gaining and there is progress with their milk supply.
> 
> She is not using a rental pump, I forgot to suggest that. The last mom with low milk production complained that it didn’t help. (But i have had other moms find it helpful) 
> I was also sent this reccommendation by someone on this list for MotherLove brand  More Milk Special Blend because it has fenugreek, goat’s rue and blessed thistle, which she says work better when blended or ingested together. 
> https://www.motherlove.com/product/more-milk-special-blend-capsules <https://www.motherlove.com/product/more-milk-special-blend-capsules>
> 
> I will be looking these up myself but also am interested in other’s experience/knowledge on this list.
> 
> In my practice, I’ve relied on milk removal to build supply. 
> 
> I have tried to read up on herbs in the past but haven’t really  reccomended them myself. 
> 
> Thanks again
Carol Tenneriello RN,IBCLC
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