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Wed, 28 Jan 2009 18:36:43 EST |
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I was hoping that someone could help me figure something out. I am trying
not to overlook anything nor am I trying to create a problem where there may
not be one. I have permission to post.
I had a mother call our office the other day with a question about her
milk supply. Her baby is 11 weeks old and within the last week or 2 has
started to nurse from each breast for only 3-5 minutes. When she returns him to
the breast for any longer time frame, he fusses and cries. Shortly thereafter,
he can be soothed and is happy for another 1 1/2-2 hours until the next feed.
So she started pumping with her Pump N Style after feeds and had an output
of 1/2 oz. The baby sleeps 7 hours at night. Ten days ago, she called another
LC who is in her peds practice and that LC recommended fenugreek. She did
note a smell of maple syrup but no increase in her supply. She had noted
occasional green stools from the baby but an increase in those, along with
fussiness and gassiness. She also admits to a fast MER.
I had her come to the office so I could observe a feeding. The baby did
what she said--ate for 3 minutes each breast then stopped. He would pull of
the breast, fuss, return for a few sucks and the fuss some more. Eventually
she calmed him and he was a very happy baby. No arching seen. His birth weight
was 7-11 with steady weight gains each week or month seen. His current was
12-5 which was an appropriate weight gain since birth. I did a pre and post
feed weight and this visit, he took only 1.1 oz.
I tried to reassure her that babies at this age are more effective
eaters and don't spend as much time at the breast as they used to as newborns. He
is very developmentally appropriate, maybe even a little ahead of the curve.
She rented a hospital grade pump days before she came to see me. I
recommended that she discontinue the fenugreek as this may be increasing the baby's
fussiness and green stools. She is to return in a week for a follow up weight
check. I did not see any reason to discontinue the pumping and we switched her
herbs to More Milk, without the fenugreek.
I can't say without that weight check if he is one of those babies that
lives off mom's MER and good supply. His weight gain is on target and not
excessive that would made me think over abundant supply. I truly feel that she
is worrying about nothing-she and her husband both admit that they tend to
overreact. I explained to her that it is not unusual to get 1/2 oz with pumping
after a feed. She has not supplemented with any formula. When the parents
have offered the occasional bottle, he will take 4 oz.
I appreciate any words of wisdom, points of view.
Allyson Michaels RN, IBCLC
Charlottesville, VA
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