HI
I think it was Kiki who had a client w/ low supply. The first thing I try to
do, as you did, is to try to figure out if it is primary or secondary low
supply. The best clue is whether or not the milk 'came in' on or about day
2-5. If so, then I go with the assumption that the potential of adequate
milk making is there. The management is really the same, efficient and
frequent drainage of the milk and add galactagogues if you can.
I agree with another poster who said your case is probably acquired low
supply. With the SNS or other supplementer, one can have the mother start w/
the tube clamped. Watch for nutritive suck (NS) and add breast compression
when NS ends, switch to other side and repeat. Then open the clamp and have
the baby drink from the supplementer's supply. The mother can then express
by pump or hand if she can any leftover milk in her breasts. Of course, the
mother has to be aware of how tired her baby is getting, this is
particularly impt for premies. The mother may not be able to do all steps w/
each feeding, depending on the demands on her time.


Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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