Mother has given me permission to post her situation. Mother was dxed with
mild MS about 3 years ago, presently in remission. Gave birth to 36 wk twin
boys 10 days ago, C-Birth. Was pumping fine and one baby at breast until 4
days ago. Changes were: nursing baby developed nipple confusion and mother
was convinced to change from a Lactina (with which she was getting an
adaquate supply) to a Classic. Within 3 days on Classic milk has dropped
from 3-4 oz per q2h pumping about .5 oz.

My perception is that she needs the Lactina back! (Never one to mess with
what isn't broke myself,but someone else told her a Classic was "neccesary"
for mothers with babies in NICU, so she switched.)One baby is home, one is
still in NICU. (The baby in NICU was the one who was nursing before bottles
were introduced.) I asked about cup feeding and she said her
hospital "won't do it." I know the consultant there and I know it is done
frequently. Mother seemed upset that I was not able to go into NICU with
her to work with hospitalized baby. I do not work at or have On Site privs
at hospital where her baby is being treated. I will see her and baby at
home tomorrow.

Question. We talked about Fenugreek and when I asked about blood sugar
mother said she "thought" she had low BS. She never tested low in medical
situations, and bought herself a blood sugar monitor, W/O medical
suggestion. Claims she can't remember what her readings were. This was just
before she became pregnant. I am worried if Mother does actually have blood
sugar problems, the Fenugreek may cause some adddional blood sugar drops.

I will be seeing her tomorrow morning and have already suggested she get
the Lactina back. Mother advised to perhaps consume oatmeal and we will
talk about the possibility of Domperidone. She says her doctor "doesn't
listen" and Mother seems extremely stressed and rejects many suggestions.

Mother is also consuming 1.5 GALLONS of water a day! I suggested she may be
hyperhydrated, perhaps having a negative impact on her supply and she did
not seem receptive to trying to even slightly decrease fluid intake. She is
NOT diabetic.

I wonder at the saftey of Fenugreek and possible low blood sugar (although
it was never caught or diagnosed by an HCP or during pregnancy.) Does
anyone know of any contraindications of normal use of Fenugreek in women
with MS and reported low blood sugar?

Thank you.

Wish me luck tomorrow! This will NOT be an easy one.

Mary Jozwiak IBCLC, RLC, AAPL, LLLL
Private Practice

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