I'm working with a mom with low milk supply and thought I'd run it by all of
you to see if I'm missing anything.  First baby, 32 years old.  18-hour
labor, 2 1/2 hours of pushing, vaccuum and forceps tried, finally C-section
(is it just me, or is anyone else seeing more of these horrific labors
lately?).  No meds in labor, spinal for C/S.   Baby weighed 9-7 at birth,
down to 8-3 at 6 days.  I saw them at 7 days.  Very educated, knowledgeable
family, good support system, mom very motivated.  No sign of breast fullness.
 According to mom, baby nursed well, long and often from the start.  No sore
nipples.  Baby well-attached at breast, swallows well for a few minutes, then
stops swallowing, shuts down, wakes and fusses when taken off.  Typical
inadequate intake scenario.  Had been given a little ABM, not too dehydrated.
 The only clue I could find is that mom said she "lost a lot of blood" during
birth process.  Has anyone had any experience with this?  If this is indeed
related to large blood loss, in your experience does the milk supply ever
increase?
     I set them up with an SNS, which seemed to work well for them.   Also a
hospital-grade pump.   Baby is now gaining well.  They later went to see
hospital-based LC for trouble-shooting SNS difficulties.  I talked to dad
today, and baby is taking 3 oz. per feeding with SNS.  When mom pumps, she
still gets less than an ounce.  I have been in consultation with hospital LC,
whom I know, and we have both encouraged mom to do whatever combination of
SNS use and pumping she can handle.  Any other suggestions?   Much
appreciated.

                             Miriam Levitt RN, IBCLC<[log in to unmask]