Hi all,
I have a question regarding the use of fenugreek.
I'm wondering if we can expect the increase in milk production to occur
simultaneous to the increased diaphoresis/sweating. I have a Mom that has
been taking fenu x 5days and today noticed a large increase in sweating and a
slightly noticeable increase in breast fullness. If so, do we deduce that the
potential benefit has peaked as well?
If anyone cares to offer more input, I will detail the case below;
Mom called because her one month old, 1st baby, hadn't returned to BW.
BW=6-4, 1mth visit 6-2. On exam baby appeared cachectic, mildly jaundiced,
skin turgor tenting but vigorous, alert, ferociously rooting and sucking on
pacifier, stooling and voiding "frequently" per Mom. Pedi, on visit the day
before, had requested supplementation but Mom was resistant so pedi agreed to
hold off til after visit with me. Mom's breasts appeared smallish and
assymmetrical ie. left 2xsize of right and somewhat conal in shape. Milk
easily hand expressed from each side. Details of typical fds per Mom revealed
that she had little understanding of the mechanics of an adequate latch or
nutritive suckling ie. she thought every suck was a swallow! With positioning
assist in f-ball hold, baby latched deeply and with instruction Mom quickly
was able to discern (a very bright lady!) suck/swallow. With massage, Mom was
able to elicit 2 discernible letdowns per side but periods of active suckling
were very brief, 1-3 minutes after letdown. After letdown subsided baby would
become frantic, which Mom was easily able to understand at this point, as
frustration d/t lack of flow. She had been managing his "irritability" after
fds, up until this pt., with a pacifier.
I left her with a plan to feed and pump every 2 hours throughout day, no
longer than 3hrs. at night and to keep fdng and followup pumping total time
to under 1/2hr. 2 Days later I returned for f/u visit, wt. check; wt.
remained the same and fdng appeared the same. She was able to accrue 1-11/2
ozs EBM which she gave via bottle at night fd. Visit scheduled for 2 days
later revealed 1/2oz difference in wt, little change in fdng character thus
it was decided to add supplemental nursing system with formula at each fd.
This Mom began last night and on speaking with her today she is easily
managing system and gives 1oz supp per fd which allows fdng freq of q21/2
hrs, a little less frequent to allow for longer time at breast. Fdng and
pumping takes about 45mins. Today she has noticed that she is pumping
slightly more each time and that baby will settle after fd with minimal
pacifier use. My plan is to establish some wt gain, evaluate responsiveness
of supply to fenfreek use/ increased stimulation and plan accordingly. Any
ideas?
sorry so long!!
Lynn Shea Rn,Bsn,Ibclc
Franklin , Ma
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