This poor mom, with son with leukemia, upcoming c-section, high anxiety,
would benefit from as simple an approach to breastfeeding as possible. I
would recommend the Lact-Aid supplementer since it can be used with mom lying
down and has a more physiologic flow, obtaining colostrum or mature milk
from a milk bank, a small amount for avoidance of early supplementation to
start anyway, and that she consider taking goat's rue now and malunggay now.
Arranging for her husband or helper to keep baby skin-to-skin with her
following delivery and having that in her birth plan and discussed with OB and
anesthesiologist. If pumping is doable for her then fine, but if she
feels it would be or finds it to be too overwhelming, especially when home,
then I'd forego that so she can just breastfeed with supplementer and enjoy
her baby. For this baby, getting breastmilk would be of even more importance
due to history of diabetes and formula would be given not glucose water,
not recommended for hypoglycemia.
I currently have three low supply moms using malunggay (a food based
supplement whose info can be found on Go-Lacta website) all three with good
results. My daughter is one of these moms and reported within a couple of days
she saw more swallowing by baby and her pumping yield increased (she's also
on other supplements, but felt the malunggay, started later, was/is a big
help). I'd also suggest this mom try Rescue Remedy for the anxiety and
sleeplessness now and post birth. There are likely other things that could
help, but a good support system, help with meals and housework, at least
daily follow-up by phone and encouragement as you stated that she can
breastfeed regardless of milk yield would all be helpful.
This mom has many obstacles to overcome and losses (loss of normal birth,
illness of son so loss of healthy child, possible loss of exclusive
breastfeeding) to mourn so ongoing support and guidance are crucial for her,
family and outside sources, in addition to LC. Acknowledging her fears and
upset can be a start and letting her feelings begin to flow could aid in her
milk flow. I think, too, as practitioners, we need to share and express our
own feelings when confronted with difficult cases so we can avoid counter
transference and be there for the client. Good luck helping her, and take
care of yourself, too.
Barbara Latterner, BSN, RN, IBCLC
She had breast reduction surgery after her last baby, now 8 years
> ago (last child is 9 now). does have good sensation in nipples,
> (respond to cold, not inverted etc.) went from E to B cup. Not much
> size increase in breasts during pregnancy, one side a little more
> than the other. Also has a 13 year old son with Leukemia and is very
> nervous about that. Can barely sleep and relax as it is, and is now
> hoping to have enough milk for this baby (EDD 4/4/10 but will be
> induced next week because of Maternal Diabetes). She nursed her
> other 2 boys and is very much looking forward to that experience and
> close bonding again. She is wondering about SNS system (which one to
> pick) and herbal supplements and when to start using them. Is
> reading "defining your own success..." by Diane West. Also has GDM
> and is worried that the baby will need sugar water after birth.
>
> I told her that stimulation and milk removal is the biggest key to
> success, nursing within the first hour or ASAP after delivery,
> writing down all feedings and diapers after the baby is born, nurse
> both sides at every feeding, not to restrict in any way and that if
> the baby should be sleepy in the first few days she should be
> pumping every 2 hours on both sides. I also suggested relaxation
> and guided meditation (relaxation for new mothers by Jessica Porter
> also known for hypnobirthing). Told her that L2 may be a little
> later than with her other 2. Made sure that she knows that the baby
> may need extra weight checks. Reinforced that breastfeeding can be a
> success even if the milk supply is not 100%. And on top of all this
> I advised her to try and stay as relaxed as possible ;) I know, a
> lot of information, but there are just so many issues here. Any
> help would be greatly appreciated! Thank you.
>
>
> Loes Lindsay, RN, BS, IBCLC
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