<<<<you asked>>>

1. How does the mum know how much supplement to give if she is trying to
reduce the supplement and increase her supply? She had been trying to
cut back the supplement and nurse more but she was very apprehensive
about this. How do you know how much to cut back? How much supplement do
you give? How do you know if the baby is hungry or just likes the flow
from the tube? How much can you cut back?
    ****The SNS  works because a valve controls the flow.  I would be VERY
careful about cutting back the amount unless this mom KNOWS she is producing
milk. Many times a breast reduction severs nerve endings (as well as the
ducts) that supply sensation to the nipple, as well as the nerve pathways
that increase prolactin levels. So a mom may or may not be able to produce
enough milk to feed her baby directly from the breast. Knowing how much to
use as a supplement depends on the baby's weight/age and nutritional
requirements.*****

2. Do herbs and medications work for a mum with a breast reduction? Does
the supply increase but there may not be enough ducts to empty out of?
How does this work?****See answer to above question. I'm not sure if the
herbs/meds can regenerate nerves. Someone else can correct me if I'm wrong.
It may slightly increase supply from the existing, functional prolactin
receptors in the breast. Maybe you can do some reading on the anatomy and
physiology of milk production to understand this better. Auerbach and Riordan
or Ruth Lawrence do an excellent job of explaining.
This lady may just have to accept the nursing relationship that she already
has and learn other ways to feel fulfilled in her mothering.
Mary Kay Smith, IBCLC
Romeoville IL

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