Hi Erin,

You say you have been in contact with this mom. Have you seen this dyad in person and, if not, can you or someone else do so?

There may be an issue with the latch, using the supplementer, using the pump, flange size or whatever.



It seems she is telling you she does not like to pump, however I would talk to her about the importance of expressing in her particular

situation, and try to find a way she can work this in. Breastfeeding with the supplementer could be the primary thing, however. In addition

to co-sleeping, babywearing, STS.



If she will pump, I would suggest a hospital-grade pump, used double, and check the flange fit. If she would rather hand express,

make sure she knows how to do that. I agree with the galactagogues and I would try to ensure good nutrition for healing and for her anemia.

From what you have posted, it may not be that she is willing to pursue other tests or procedures. She should know about

things that could decrease her supply like contraceptives, decongestants, long stretches without bf, smoking, etc. She probably really needs

someone to talk to about the whole postpartum experience; however unavoidable, anyone would be traumatized by that.



Laurie Wheeler RN MN IBCLC

Mississippi USA





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