>The biggest issue is that the baby has become lazy, due to the milk 
>flowing freely and easily from the bottle, hence the suggestion of 
>expressing to point of MER, so the milk flows as soon as she 
>attaches.  I have also suggested temporary use of a nipple shield as 
>this has been shown by Paula Meier to help milk Transfer...!!  She 
>has got some Fenugreek and milk thistle today.  I will follow up on 
>Wednesday.  Thanks for any help recieved...


I don't think we have much evidence that babies can become 'lazy' 
(and I feel it's not really fair to use these words with babies, 
anyway....sorry!) or unwilling to put more 'effort' into removing 
milk.

Milk doesn't necessarily flow more easily or freely from a bottle in 
fact - the physics of the suck/removal is *different*, for sure, and 
the baby still has to work at it :)

Babies tend to feed less well at a less 'rewarding' breast - the low 
supply has been caused by the early introduction of formula and the 
increased use of it, and the baby rejects the less productive breast 
in favour of the productive bottle.

Lots of skin to skin, feeding ad lib, switch nursing, breast 
compression, gradual reduction of formula consistewnt with ensuring 
the baby is well-nourished....and galactagogues too if she is happy 
to take them.

Personally, I don't see the benefit of expressing to the point of 
MER....this could interfere with being responsive to the baby and 
making sure the baby gets on to the breast at every moment she looks 
like she might want to :)

Heather Welford Neil
NCT bfc, tutor, UK
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