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Thu, 25 Aug 2005 15:52:00 -0400 |
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I am posting this query with permission from the mom, in hopes of getting
some other opinions. Baby is 5 mos. old. Mom returned to work when baby
was appx 8 weeks old. She works 12-8 PM two days, 2-8PM middle day, then
10 AM - 4 PM on Saturday. In the beginning she was pumping adequate
amounts and baby was "fine". She wasn't enthusiastic about the bottle but
things were progressing nicely. Mom contacted me when she had been back to
work for about 2 weeks because her pump output drastically diminished.
After some troubleshooting we determined that her pump motor had failed.
Things rebounded sometwhat, but now she is upset because her baby has
begun to want to nurse almost constantly all night and has fallen off her
previous weight gain pattern to the extent that baby's pediatrician has
begun recommending this mom use galactagogues to increase supply. Mom
reported that baby absolutely refused breast when she was on fenugreek.
She has now begun reglan (three days ago). I brought up the following
points for her to consider: 1. could baby be ready for solids? I know this
violates the 6 month "standard", but does the baby know that? 2. I told
her that she can take all the herbs/drugs in the world, but if she doesn't
empty the breast more often her body will not sustain increased
production. She agreed to look again at replacing her pump equipment and
upping frequency of pumpings. (It has been a tough sell getting her to
consider the inadequacy of her current pump. long story...) 3. She has not
gotten her period back yet. 4. the baby is not overly fussy or frantic.
Just wants to nurse a lot. Mom does notice milk leaks and sprays when baby
is nursing. 5. baby is very distractible lately, lots of pop on, pop off
behavior. Thrush has been ruled out. If it weren't for her pediatrician's
concerns about the weight gain I'd lean in the direction of telling her
that her baby may just be reacting to her absence and wanting more
nighttime attention. There is also a lot of incresed tension in the house,
as her 5 year old step-son has moved in with them full-time. I explained
that even though they are very happy to have him there, stress of any
kind, even good stress, can affect babies and milk supply. Is there
anything I can offer her in the way of advice/reassurance? She seems very
willing to try everything I suggest except getting a new pump and having
baby in bed with her. Baby is in the same room however. Time & travel
constraints do not permit caregiver to bring the baby to work for nursing
during working hours on a consistent basis. Baby does not get pacifier and
will refuse formula bottles when offered. Baby has been getting "a little
cereal" once in a while, but mom did not see that this made a difference
in her behavior or pattern so she discontinued. Sorry to go on so long, I
am just wondering if this is a serious problem, since the pediatrician
is "very concerned" about this baby's faltering gains. Thank you for your
consideration. I am hoping you all may see what I am missing.
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