Please forgive the repost, but although I saw my orig. post listed, I have had no responses. Did I do something wrong? I get my CLC certification in April and intend to sit for IBCLCE in 2010. As it turns out, mom only really has supply issues first 3-4 months, then things seem to resolve. Does no one have anything to offer in regards to my post. I am genuinely just looking for someone who has maybe deallt with a similar case. So, here we go again . . . .
Good day to you, Wise Ones!
I am a Peer Breastfeeding Counselor with WIC, recently hired FT. Have been volunteering for many years. Here is the issue:
I have a mom who is due to deliver her 10th child (1 set of twins
among them) in 3-4 weeks. She has just contacted us so we are
brainstorming to know what path to take to help her avoid any pitfalls
concerning her hx of low milk supply. Her three most recent have been
unmedicated water births. Six of her children were born at home but she
plans to have a hospital water birth with this one.
I have only spoken to this mom on telephone, although I have a home
visit planned for next week. I work under supervision of an IBCLC, who
is familiar with this mom from past. My boss (the IBCLC) has met with
this mom and says her breasts are rather tubular. Mom is of slightly
above average weight and is 42 years old. She is nursing her 21 month
old about 3x a day, and reports she finds it uncomfortable right now,
but is hoping to regain some of the joy of nursing that child after the
baby is born. Mom is wary of medical interventions, will only
supplement with "raw" soy milk, rice milk (or should I say juice), or
goat's milk. She is holistically oriented. All of her children have had
low weight issues and she has been compelled to supplement all. She
does not routinely sleep with her babies, although she does keep them
in the same room. When she does bring them to bed, she is in the habit
of tightly swaddling them. She has had her thyroid levels checked in
the past with results of normal levels. She has no hx of anemia.
She has taken herbal galactagogues in the past and has used breast
compressions while nursing. She says she notices "some" difference from
these things.
We are brainstorming to come up with a plan for her to follow in
first days/weeks, to hopefully avoid the problems she's had in the
past. Although her technique may need some adjustments, it seems clear
to me that there is something metabolically or physiologically going on
that's not been identified. So far, we plan to urge her to hyperlactate
in the first 10 days or so by beginning pumping at day three and then
assessing at 10 days post partum. Mom spends a lot of bonding time with
baby in first hours, but seemed intrigued when I spoke to her about
unswaddling baby and concentrating on lots of STS time well after
birth. We are all studying to come up with a game plan and I just
wanted to put this out there in hopes that some of you might have some
ideas that would help us identify the problem.
Basically, with 10 kids, I consider this woman knows plenty about
nursing. She is also a self-study, though with 9 kids, there's not a
lot of time for that, I expect. She has asked us -- albeit a little
late in the pregnancy -- to help her start out with the optimal
situation in order to try to avoid the problems she's had in the past.
I am enjoying the learning experience, personally.
I'll be looking forward to any pearls of wisdom any of you might have to share. Thank you in advance.
Liane Varnes
Lactivist
Peer Breastfeeding Counselor
Ga. PH District 2 WIC
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