Jessica writes:

PTP. 15y/o primipara.
I initially saw them for sore nipples/difficulty latching.
7/12: baby born weighing 7#6oz.
7/16  lowest weight was 6#13oz when I saw them in my office. Baby had a
tongue tie that was clipped that same day, baby was 4 days old.
7/20: pre & post weight feeds showed baby able to transfer 3oz and at that
time. Baby up to 7#9oz prior to that feed. Mom had gobs of milk.
7/23 she was 8#2oz.


That's all good - actually the weight gain is greater than would be
expected, and 9 oz in 3 days and 12 oz in 4 days is  huge (not saying
abnormal - but huge :) )

8/3 mom reports shes lost her milk supply. Hasnt started any new
medications, herbs, hasnt done anything differently. Bleeding has tapered
off significantly. baby incredibly fussy, started formula supplementation.


The key word here is 'report'.  Far and away the most likely reason for the
'milk loss'  (IMO) is a combination of mother's perception and formula
supplementation.

There's a 15 year old here - maybe she has relatives living with her who
tell her the baby is always hungry so she can't have enough milk. For those
stellar weight gains, the baby will have been feeding *a lot* round the
clock. Maybe she has stopped feeding the baby at night and started to give
formula, maybe a relative has started to 'help out' with supplements. You
say the family is supportive and they may well be, but not in this regard.


Saw mom in office, breast were very soft & squishy. Able to express just a
few ml both by hand expressing & double pumping after several attempts.  I
provided mom with an SNS to feed at the breast, as well as a Double
electric pump, mom did skin to skin & round the clock feeds for 3 days with
no change.


No change in what, though? What is the weight now? If milk supply has
plummeted, 3 days of skin to skin/feeding ad lib might not be enough.

It seems to me it would be worth finding out a little more about the extent
of supplementation and continuing to go back to basics - skin to skin,
feeding ad lib, co-sleeping, with breast compression and switch nursing if
necesssary.  *Personally* I would not suggest an SNS or pumping, or further
medical investigations at this stage.  And give her a week before weighing,
with maybe a supportive phone call in the middle :)

If there is a breastfeeding support group or LLL nearby, maybe she'd like
to take part in that, too?

Heather Welford Neil
NCT bfc, tutor, UK

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