In the last week I have had 3 LLL calls that were much more difficult
than usual (or at least so it seems to me).  Today I had one about
relactation at 5 weeks and one about insufficient milk.  Here is a
summary of the second call.
        Mother with two week old baby.  It is baby #4, 10 years since the
last one.  Baby was in ICU for 48 hours to r/o sepsis.  Then began
nursing.  While baby was in ICU mom used a hospital pump fairly
regularly but got nothing out.  She also did some hand expression.  From
2 - 10 days mom had breast changes, baby nursed well with audible
swallows and seemed to be doing well.  A few days ago the breast fullness
went away completely, breasts seem to be very soft, let down is delayed
and baby screams after a very short period of sucking.  She then scarfs
down about 2 ounces of BMS if it is offered.
        My thoughts-
Continue to use pump/hand express after every nursing
switch nursing for a while if baby wants faster flow
shorten interval between nursings
breast massage before and during nursing
check with MD about retained placental fragments, thyroid problems or
other hormonal issues
consider oatmeal and herbal galactagogues
try to use alternate feeding method instead of bottle

Have I missed anything important?

TIA
Sarah


Sarah Friend Barnett   LLLL, IBCLC
Bronx (New York City), NY  -  [log in to unmask]
" You are not obliged to finish the task,
 neither are you free to neglect it."       R. Tarfon

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