The baby is small and so the first thing I would do is to ensure a very deep
latch. Is the baby in fact full term, a premie will need help. The mom's
breasts are small so maybe she is engorged somewhat and needs RPS to help
the milk flow and the baby to latch. I also wonder about the frequency of
feeds. You say she pumps after every feed which is every 2-3 hrs so that may
be too low a frequency. I would shoot for 10 to 14 feeds at least every 24
hrs. If she truly did not experience noticeable breast fullness then you
would want to help her investigate causes for failed lactogenesis II and in
the meantime use a nursing supplementer at breast if baby can latch and a
hospital grade pump to express often and use in supplementer with formula or
donor milk if needed.\
LAURIE WHEELER, RN, MN, IBCLC
POSTING FROM HAWAII

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