I am working with a mom whose baby is slow to gain.  She was not back to birthweight at 2wks, mom rented a baby scale to monitor weight & intake.  At 3wks, baby had only gained 2oz.  I advised mom to see an IBCLC, but Mom did not want a consultation and was sure the baby was latching properly.  I persuaded her to let me watch the baby nurse.  Mom had thought the baby was supposed to have more of the upper aereola in the mouth, so she had her latched too high and baby was basically just on the nipple with the lower jaw.  I showed the mom a proper latch and how to tell if baby is swallowing.  She watched baby nurse and stated that she had never seen her actually swallow before.  Baby is very sleepy and mom thought baby was just "a good baby".  As a result of babies poor latch mom's milk supply has dropped significantly.  Since Monday when I saw them mom is nursing baby every 2hrs, pumping with a double pump, giving baby pumped milk and following up with formula.  The total amount baby gets via bottle (mom does not want alternative to bottle) is 2oz (usually 3/4oz ebm followed by 1.25oz formula).  She is taking fenugreek 3 capsules 3x per day.  Mom's supply has not shown much of an increase in the 4 days since she began the protocol (she was getting 1/2oz pumping every 2hrs and is now getting 3/4oz).  The mom is very determined to make this work and get the baby nursing and on 100% breastmilk.  Is there a better protocol to follow to get the baby gaining and increase mom's milk supply?  How soon do you reasonably think she may get a full supply?  Baby's current weight is 6lbs 11oz, birth weight was 7lbs 5oz.  The mom is exhausted and was under the impression that she would have a full supply back after just a few days.  I appreciate any input you can give.  

Mellanie Sheppard - hoping to sit for IBCLC 2004


P.S.  The nurse-practitioners advice was "give baby ten minutes on the left breast, 10 minutes on the right breast and then 10 minutes of soy formula in a bottle".  Oh, and she told her not to see an LC because "LC's don't believe in formula and your baby will starve."  Ugh!

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