Anne,
I would not use the protocol. I would recommend that the mother do STS and
babywearing, co-sleeping. I would ask mother to rent a hospital-grade pump
and use it up to 8-10x per day, or whatever she can manage. Even very
frequent 5 min double expressions can help. I would also suggest an herbal
galactagogue (I usually refer to Motherlove Herbals). Yes, when baby takes
an interest in the breast, a nipple shield can be used to make the
transition, and if the milk supply is not very high yet, a lactation aid can
be used (I like the homemade ones).
The herbs can work if their is prolactin-inducing activity like STS, and
with regular milk expression. Hand expression can be used in lieu of pump.
I would also suggest changing the way mom bottlefeeds to a more bf-friendly
position and eliciting the latch, ala paced bottle feeding.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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