Hello Lacnetters!

     Alright, I confess I've been lurking for about a month now trying to
work up the courage to post.  Well, today a problem dropped in my lap and I
just know there is an answer out there.  This is my first posting so
please...be gentle!

     I'm a student lactation consultant in a small rural hospital and a Mom
called today with the folowing dilemma.  She gave birth on the 4th of July
(baby is NOT named "Uncle Sam") to a boy; gestational age 28 weeks; weight
885 gms.  Babe is doing well in a tertiary care hospital NICU (weight Approx
950 gms) and is just about ready for po feeds.  This Mom says he WILL NOT  be
fed with abm.  Yes!  She has been pumping since he was born and can't seem to
produce much of anything.  She is using the hospital's pump when she is there
which is the better part of each day.  At home she uses a hospital grade pump
that was loaned to her by the local WIC.  She pumps q 3-4 hours for about
15minutes and the most she has expressed is about a total of 1 oz.
     She says that earlier, she had been getting a bit more.  Her mental
state is wearing down, a factor which we discussed that might be adding to
her problems.  I suggested that she trying lowering the suction level (she
had been using the highest) and pumping q 2 hours.  Put on some music, look
at a picture of her beautiful new baby, even try a glass of wine or a beer.
 She says her breasts don't even feel full anymore...I guess they did at one
point.
     She is really committed to BF so she's willing to try anything.  The
doctors at the tertiary care hospital have suggested Reglan which her gyn had
never heard about.  I told her it was used commonly for production problems.
 The local gyn says he's hesitant d/t depression (a side effect according to
the PDR) and he doesn't want her to sink any lower.
     Is depression really  a factor with Reglan? What is the standard dosage?
  What else can I try with this Mom?  She seems to respond well to
encouragement and since she wants this so badly for her baby, I don't want to
miss a thing!
Thanks for the help...I'm waiting breathlessly for your pearls of wisdom!!!

from the Sauerkraut Capital of the World, Phelps, NY
Barb Hannevig,RN