Hi All,

 

Actually, Heather you are right on but I will add a bit more:

 

>  She lost a lot of blood and had low blood pressure, low hemoglobin, 

>and low temperature, so  baby went to the normal nursery for 48 

>hours, during which time she had some glucose water and several 

>bottles of 20 mL formula after she lost 10% of her weight.

 

 

>>There's one cause of low milk supply there - separation of mother and 

>>baby for 48 hours with no expressing or feeding.

 

There are actually 2 possible reasons here - the first Heather got.  The 2nd
- Large loss of blood.  When the body loses a tremendous amount of blood it
can certainly set back the production of milk - sometimes permanently with
Sheehan's Syndrome if the loss is severe enough to effect the pituitary
gland.  There is also the anemia going on which can affect the milk supply.
I am not surprised she is having supply issues - I would, rather, be
surprised if she had no issues!  But, then I have worked with these moms
before.and learned the same way you are learning now.  :-)  Ask those
questions!

 

With everything this mother has been through - the fact that there was no
stimulation to breasts at all until day 3 - no pumping until day 5 and mom
is BF every other feed and only pumped 4 times in 2 days - that is certainly
another big red flag for low milk supply. 

 

My first take on this is to watch closely for possible Sheehan's Syndrome
and get more stimulation going.  Also, rather than having her take only
Fenugreek - I would go for a combination of herbs such as More Milk Plus to
give more of a jumpstart.  But, moms in this situation need to really watch
their bodies and how they are feeling. 

 

This poor mom has had so many triggers for low milk supply it isn't funny.
I agree to stay away from the Reglan.  I would really encourage her to keep
close contact with her Dr about Sheehan's and the anemia.

 

Good luck to you and especially to this mommy!  Maybe she would consider an
SNS to keep baby on the breast?  It can be extra work, but if she is up for
it.  Also, she needs to pump after baby has nursed - and she needs to pump
at least 8 times in 24 hours.  If she is too tired, then she could shoot for
8 and settle for 6 increasing the number of pumpings/nursings as she feels
better.sometimes we have to work within mom's abilities.and hope for the
best.

 

Jaye Simpson, IBCLC, CIIM

 

 

 


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