Dear Wise ones,

 

I need to find out how often other IBCLCs see almost no milk production
with a woman without any risk factors whatsoever.  I have a case which
is confounding me.  Baby born at 41 weeks to primipara latched well at
birth.  No pertinent medical or past surgical history. Normal delivery,
with no excess blood loss.  Breasts normal size and shape with breast
changes noted during pregnancy.  Baby latched well from birth.  No
engorgement or fullness felt during first week of life.  I saw couplet
on day 7 because baby was "feeding all the time".  Breasts were soft
with drops of colostrum expressed.  Infant's latch appeared normal,
palate and tongue normal. Nipples everted non tender and non
traumatized.  Baby transferred 4cc's over breastfeeding session, which
included compression.  Mother encouraged to use hospital grade breast
pump and supplement with EBM.  By day 10, baby had lost 10% birth
weight, mother frustrated and tired and baby hungry!  Temporary SNS
started with 1 oz. of ABM every 3 hours. Added fenugreek and blessed
thistle.  Seen on day 14, with no changes except baby more content and
gaining weight. Baby transferred 4ccs from breast before adding
supplemental nurser. Today, baby is 18 days old.  Baby is within 3 oz
regaining birth weight and is getting 2 oz of ABM from SNS  every 3
hours plus feeding at the breast without SNS very often.  He transferred
12cc s from breasts.  I am thinking of suggesting prescription meds,
getting prolactin level and thyroid studies.   What am I missing?  Do
idiopathic cases exist?  I have never used a prescription for primary
milk insufficiency and do not know of its efficacy. Could this be very
delayed onset of lactogenesis?

Thanks for any advice,

Mary Westra RN, IBCLC


             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome