I have a fairly urgent question regarding the use of the oxytocin nose spray
after having had a c-section. I have had contact with a new mother, who
through insufficient help (and basically "old fashioned" advice) in the
first two weeks after the birth of her daughter, is needing to increase her
milk supply. She has been using nippleshields since two days after the birth
of her daughter (who is now 19 days old) and her milk supply is extremely
low. Her daughter was 260g under her birth weight at 17 days  - I saw her on
day 17 and her daughter was clearly unable obtain a feeding with the
nippleshield, and the latch without it was impossible. Constantly falling
asleep and I feel (and this is not a medical assessment but a "gut feeling")
that if I hadn't sent the father out to a pharmacist to get some ABM then
things would have gone from bad to a situation I don't dare to think about.
Anyway, she has put on 70grams in the last two days with expressed milk and
ABM, so things are looking up. However, the mother asked her doctor for a
prescription for oxytocin to help with expressing milk. Her doctor said that
it was not safe to use oxytocin after a C-section? Does anyone know if this
is so? And if it is safe does anyone have any concrete references to show
that it is safe? If its not safe, then why?

Whether she actually needs the oxytocin is questionable. Two days ago she
could express only 1-2ml from each breast, now she is expressing 10ml from
each breast, per pumping session. In my book that's an increase. Anyway,
we're going to keep working on the milkproduction and see if we can get her
daughter back on the breast over the coming week.

Thanks in advance

Sara Bernard, The Netherlands

(ps - the only advice she got from the district nurse was for herself to eat
fatty fish and caschew nuts!. Nobody looked at the baby feeding or milk
transfer? I'm still mad about the fact that the same nurse had also seen her
the day before the mother called me and did nothing about the breastfeeding
and did not recognised that there was a problem.  Plus the fact that I had
to pick up the peaces a day later, when I'm not medically trained to make
that sort of assessment. Also want to say that I'm not generally nurse
bashing - only this one.

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