>I am working with a new Mom (permission to post), first birth,
>identical twins, born by c/s at 38 weeks due to both being breech.
>This pregnancy was after 3 miscarriages and a history of high
>prolactin. She took one half comed and one shot of Oatral. She was
>on Pregnal for the first seven weeks 2 time a week. She has mild
>hypoplasia.
>
>She breastfed the babies at about 8 hours after birth and due to a
>total lack of encouragement from hospital staff (including the
>ibclc- according to what she said) she mostly bottle fed and did not
>do much pumping.


She's had a pretty crummy start, hasn't she?

8 hours for the first feed is very, very late. Then this was followed
up by formula and minimal pumping. She saw you at 11 days after this
regime....no wonder she doesn't have much milk.

I would think this is the most likely reason for poor milk production
- far and away more likely than low prolactin levels (there is no
consensus on what prolactin levels should be, and in any case they
are dynamic, so checking is not going to yeild any helpful result.
She may well have low prolactin levels by now, anyway).

Her milk supply needs rescuing, surely....frequent and unrestricted
skin to skin with both babies, frequent and unrestricted effective
breastfeeding, with frequent ad unrestrictd expressing with an
effective pump, minimal formula. Hard work, esp with twins, but
essential, IMO.

Medication and SNS could help, too, but the main thing is *get the
babies feeding* and *get the milk supply stimulated*. SNS can be
fiddly, but when the mother is motivated to do it, it is
effective....if it's so fiddly, it puts her off trying, then it's
prob not a great idea, IME.

If she doesn't  start the rescue plan then we know that building up
and maintaining a milk supply is going to be impossible.

Heather Welford Neil
NCT bfc, tutor, UK

--
http://www.heatherwelford.co.uk

http://heatherwelford.posterous.com

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