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Date: | Wed, 18 Aug 1999 12:57:47 -0700 |
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Hi! I have been lurking for a long time-this is my
first general post. Have been IBCLC over 10 years,
currently work both in a large hospital as an LC and
a private pediatric practice an an LC.
Case study: 28 y.o. WF presented in my office with a
6 day old male infant. BW had been 9lb 3oz, was 8 lb
1oz in office. Parents had been supplementing about
4 times a day because infant was "not happy at the
breast". Had been nursing since delivery, at least
every 2-3 hours. Nipples mildly abraded bilaterally.
Positive breast changes during pregnancy. No
medical or surgical history in mother. Breast
appeared normal, very flaccid though. Could manually
express transitional milk. Observed infant latch-did
well, but easily frustrated. Sent parents home
feeding baby with bottle, mom to start DP every 3
hours, put baby to breast for comfort.
On return visit, 5 days later, infant had surpassed
birth weight. Mom had pumped every 2 hours times 3
days-no change whatsoever in breast. Never pumped
out a drop of milk, infant would not even take breast
for comfort. Mom's bleeding had decreased normally,
but cramps and period started at day 10. Mom also
having low-grade temp. Suggested she call OB and
report symptoms. At this point they have given up on
breastfeeding. I promised I would ask for
suggestions on why her milk never came in. She was
never engorged-my only possible thought is small
placental retention. Please advise. Thank you.
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