Hi Lactnet,
Just after a few thoughts requested from you all, with a complex situation.
PTP: mother's history includes
.cessation of menstruation for about a year,
.polycystic ovaries
.on the pill to encourage ovulation and menstruation.
.on clomid, ovulated a couple of times,
.pregnant, twin boys
.little breast change in pregnancy
.pre-eclmpsia, Aldomet for blood pressure
.no breast changes after birth 'milk just changed'
.never felt full, no leaking
.vaginal delivery, epidural
.bleed at birth approx 600ml
.haemoglobin low - 7- very unwell for 5days
.large pendulous breasts
.thyroid normal about 2-3yrs ago
.amenorrhoeic
.no diabetes
This woman has struggled with breastfeeding, pumping and formula for 3months
before she contacted me. Plus mastitis, thrush and initially sore nipples.
She has tried hard to breastfeed exclusively but when I first spoke to her,
her routine was breastfeed singly (she can not manage her breasts to twin
feed or double pump), bottle top up with expressed milk and formula, pump,
then practically start again.
She lives a long way (1300kms) away, no local LC, told her babies attach
well but from comments on the ph they have never fed vigorously.
I feel that the odds are well and truly stacked against her. She tried
Maxolon a few weeks ago but noticed no change. The pharmacist suggested a
second go as this sometimes proves to be beneficial.
No return of menstruation at 4 months.
What now please? It is hard to manage at a distance but I would like to
support this woman in what she has tried but her history is complex and her
hormones definitely seem to have had a mind of their own.
thanks
Sue Cowcher IBCLC
Esperance, Western Australia
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