Cathleen
I'm reading that baby transferred 30ml at a feed and feeds 10 times a day which means she's getting only 10 oz from breast per day.
Moms pumping results in a much higher output. This tells me that baby is not transferring milk effectively, for whatever reason.
After ruling out medical causes for low milk supply, I'd keep mom pumping and using galactogogues, and supplement at breast until moms supply (hopefully) increases. Then try to figure out why baby isn't transferring well -- latch, tongue tie, etc.
I recommend West and Marasco's "MakingMore Milk" As reference
Melinda
MelindaHarris-Moulton ARNP, IBCLC
Breastfeeding Medicine of South Sound
Olympia, WA
Sent from my iPad
> On Sep 1, 2015, at 11:32 AM, Cathleen Redus <[log in to unmask]> wrote:
>
> Hello Wise ones,
>
> I'm a new LC and have this perplexing case, I'd like to get your feedback on. PTP Mom is 35, first baby, no red flags in hx, no infertility issues. unplanned C/S due to breech. Breasts are symmetrical and round. Breast changes in Preg. Noticed heaviness and full feeling around day 3. Baby is 17 days old, BW: 7# 12 , weight at 13 days 7# 3, Weight at 16 days 7# 3.2. Baby feeding 10 times in 24/hrs. Baby having 4 wets and 3 stools a day. Pre/post feeding weight on day 13 showed 1oz transfer in 20 minutes. Plan for next 2-3 days -Had mother nurse every 2 hours, pump both breasts for 15 minutes post feeding and feed back expressed milk, take galactogogues as directed on pkg (she chose fenugreek). 3 days later only 0.2 weight gain. Mother reports 0.5 to 2 oz pumping post feeding depending on time of day and how well baby nurses. After ped. visit on day 16 she did a 12 hour pump test with exclusive pumping during that time. total yield was 8.5 ounces. If multiplied by 2 that is 17 oz in 24 hrs but baby needs are 19.2. I assessed the baby for tongue tie at my initial visit. There is a possible posterior tongue tie but I'm not the best at seeing these yet. If the baby's suck has affected this wouldn't we see an increase in supply with the pumping, why didn't the moms supply increase substantially with the extra pumping and galactogogues? What am I missing? TIA
>
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