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Mon, 30 Nov 2009 14:52:43 -0500 |
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Hi,
I have been working with a very dedicated mother whose child is about to turn 4 months old. This mother had extreme engorgement in the first week postpartum, to the point of milk stasis. The stasis resolved within 4 days, at which time she began to be able to pump some breastmilk using a Symphony electric pump. Her supply was quite low for several weeks following this episode, and her baby refused to latch.
Since this time, I have worked with her on a number of strategies to get her baby to latch. He will not stay on the breast, and will only chew, causing a great deal of pain. This is probably from the bottles he gets for all of his feedings, however I have always suspected that this mom's letdown is severely impaired, which is causing most of her difficulties. Here we are now at 4 months, and she is pumping (exclusively) enough to give all breastmilk at this point (30 ounces per day). She told me this morning that she pumped 19 oz in one sitting!! Her other pumpings are 4 oz proportions. She says that it takes at least 15 minutes for her milk to begin letting down, making her pumping excruciatingly time intensive. This has become very difficult, as she needs to pump at work now as well.
We had the compounding pharmacy make some oxytocin nasal drops, however this did not work for her. She has tried putting baby in the bath with her, massaging during pumping to no avail. I am searching for ANY advice from LACTNET regarding help with delayed MER to help this poor mom out. She is in tears nearly every time I speak to her.
Thanks so much,
Brenda Phipps, BS, IBCLC
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