Hi Pam,
The first thing I am thinking is she might need help with the letdown
reflex. Perhaps the way the baby is latching, not latching, or suckling, or
the pain, is not eliciting a letdown. Also many moms just don't letdown well
to a pump, esp if the supply is low.
So I would probably be looking into ways to help the letdown, like perhaps
an oxytocin nasal spray (not sure how/where to get this nowadays) or Rescue
Remedy or other herbal or homeopathic (I'm not an expert here) that would
help. I would absolutely encourage mom to continue with her efforts, letting
her know of other cases you have seen and many others your colleagues have
seen. Is she otherwise retaining fluid? Are her ankles or other parts
swollen. If so a prescription, herbal, or food diuretic might help
(watermelon, cucumber).
I would offer her the option of nursing with a supply line, when her nipples
feel up to it.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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