I wrote several weeks ago about a mom I was working with who was
practically willing to walk on nails to make BF work.  Well she ordered
domperidone from NZ (after her husband e-mailed Dr. Jack and ended up
exchanging several posts I think!) and baby has had several appointments
with the OT who does cranial sacral.  Mom's milk supply is up a lot and
OT says baby is about 50% of the way to really good suck--that's up from
about 20% before she started seeing him.  Baby is still not transferring
enough milk for a full feed--during the day he's being supplemented with
breastmilk after being at breast.  At night she's nursing and
supplementing with ABM. Mom is pumping after every feed and it takes her
about 20 minutes or more but she can get anywhere from 1 1/2 oz to 3 oz.
Now the question for all of you is this...she has really been observant
during all this pumping and it takes probably 5-7 min of post BF pumping
before another MER kicks in and then she'll get another one maybe 5 min
later.  Since baby doesn't transfer milk superbly anyway, he's not
willing to go back to the breast (instead of mom pumping) and work and
wait for these MER's to happen.  Would Syntocinin help this mom keep baby
interested at breast longer?  Is she unusual with these type of MERs?
Baby is 6 weeks, over 12 lb. (thanks to the post-breast supplementation)
and mom is REALLY tired of spending so much time pumping.  She says she
doesn't think she'll ever be a super producer, but she's so worried that
if she doesn't keep up the pumping her supply will go downhill.  What do
you all think?

Another question related to the pumping.  She's using a Pump in Style
with the bigger flanges and one nipple is bigger than the other.  It
looks to me like it's squished as it's being drawn into the flange.  I
had her try the glass flange that has an extra extra large opening today
and it looked like her nipple was actually expanding to fill the opening.
 But mom said it really wasn't any more comfortable and she thought the
nipple being squished with the smaller flange might actually help get the
milk out.  Can that be?

Any words of wisdom for this mom?  She's proud of where she is.  But
she's getting tired of all this pumping.  And she returns to work in
about a month--so she's thinking about how that is going to affect
everything too.

Thanks,
Pat Bucknell, IBCLC
Avon Lake Ohio
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