Dear Lactnetters,

I have permission to post. This moms supply is disappearing and I need your
help.

Mom: 31 yo. G1P1. normal/BMI, no infertility, symmetrical, full breast
development, breast changes during pregnancy, no hx hypothyroid, no
menstrual irregularities, no hx iron deficiency, no hx surgery etc). Very
fit, very healthy. Very sweet. Husband is equally awesome, loving,
supportive. Great family support - just a sweet, sweet family.

Full term, male infant, vigorous, healthy, no health concerns. Bubble
palate. PTT.

***Labor 27 incl 5h pushing.****

Baby nursed well from the start. Nipple lacerations (in spite of deep
latch) within 24h due to restricted oral tissues, bubble palate, moms very
dense breast tissue (almost as if she has implants but she does not).

They called me day 5 due to nipple pain, positioning challenges, 10% weight
loss (for which the ped did not recommend supplementation; just "call a
lactation consultant")

Mom is currently exclusively pumping while we await revision. aby is being
bottlefed (paced, very upright, active latch; dr brown's preemie nipple)
and nursed by her two sisters as well.

Mom began experiencing engorgement on day 6 - yes, day six. Slowly her milk
increased to a max of 8 oz/day (pumping 120-140m per day no less than every
three hours, sometimes more frequently to mimic cluster feeding).

She is using an Ameda Platinum pump with properly fitted flanges (22.5 mm,
nipples the size of pencil eraser....22.5 might even be too big. 25 mm was
huge, pulled areola into flange and caused swelling and blanching)

Hands on pumping, breast massage etc. Sisters are helping and the whole
thing is just amazing.

She's cuddling baby a lot, plenty of skin to skin, basically staying in bed
wearing panties. Revels in his his existence.

And her milk is drying up. Today, she is pumping a quarter of what she
pumped Tuesday and Wednesday (8 oz total per day)

No unusual bleeding, cramping, clotting. She is only having to change her
pad once a day....which made me wonder (at 10d pp).

This OB is generally resistant to u/s for retained fragments and resistant
to blood work.

I did speak to the mw who attended the birth and she feels confident that
there are no retained fragments.

Thoughts and suggestions?

             ***********************************************

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