I have permission to ask the list about a patient I've been seeing.  She is
32yo G2P2.  Hx of not producing enough milk with her first child.  She
supplemented after first 3 weeks and breast and bottle for 8 weeks; then
quit.  This time she delivered a 9'1" girl, exclusively breastfed until
recently starting to offer some formula after the breast.  This baby was
8'7" at two weeks.  She voided about 5 times a day, stools about 4 times a
day.  Advised her to pump after the feeds to increase supply-which she does
(using a single, electric pump; does not appear to be very effective).  I
got her on Domperidone last week, but after taking for 6 days, sees no
improvement.  Baby takes about an oz of formula after nursing.  Even
frequent feeds (every 2-3 hours) does not seem to keep the baby satisfied.
She is going to continue for awhile longer (but is discouraged).  I told her
that she may be a slow responder to Domperidone (gently suggested pump may
not be all that great), feed a little formula if baby seems to need it (also
suggested using a cup instead of nipple, but she wasn't all that interested
in that).  She is going to the Pediatrician tomorrow (not a supportive of
breastfeedng one) and then she will come see me.  All collective wisdom is
appreciated.

Nancy Hoehn, MSN, RNC, WHNP, IBCLC
mailto:[log in to unmask]





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