Dear Lactnetters,

May I ask for some help?
I got a phonecall from a mother (I'm posting with her permisson). She has a 7 month old baby boy. Until 5 and a half months everything was perfect, baby was breastfed (with occasional pacifier use), no bottles, no supplements. At that time baby became ill and was diagnosed with Nephrosis. (mother was told that this syndrome was unknown at this age). Baby was hospitalized for a month, got antibiotics for different problems ( first for nephritis, later for an upper respiratory infection), at the moment baby is taking the third kind of antibiotics. Besides other medications (one for hypertension) and vitamins and minerals and nose drops, for four weeks now he has been taking steroids (Medrol is the Hungarian trade name) and mother was told that the steroids increased baby's appetite which cannot be satisfied now. Mother's milk supply decreased to half. She is pumping but cannot initiate milk ejection reflex. When baby is put on breast he has no patience to wait for the MER and starts crying. Sometimes he doesn't want to nurse for even half a day. He only wants to breastfeed if milk flows rapidly. Mother started supplementing with formula (doctor's advice), baby gets the whole amount with spoon to avoid nipple confusion. 

Mother is under a lot of stress, seems very much at the end of her ropes. She is very concerned about continuing bfg. She is afraid that ABM will do a lot of harm to her son's weakened immune system.

She already tried breast compression which didn't help and tried expressing or pumping before bfg. to initiate let-down with no success.
I suggested she try some relaxation techniques before putting baby on breast or before pumping. I also advised her to ask her doctor about the use of nasal oxitocyn.
What else can she do?

Any and all ideas are appreciated.

Warmly,

Ibolya Rozsa, LLLL, IBCLC
Hungary

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