>A mom in my practice is pregnant for the second time with EDC in early
>December.
>Mom is a 40 y/o G2 P1001 whose first breastfeeding experience did not go
>very well.
>Her first baby was term and uncomplicated. The baby breastfed well in the
>nursery but when seen in the office on day 5 and 6 was losing weight without
>good signs of increasing milk supply.

That (IMHO) would be the time to work on checking the position and making
sure the baby was given lots of chances to stay next to his mother skin to
skin, with lots of practice. *As soon as the formula is introduced* the
breast milk supply is compromised, maybe long-term.

>At
>6 weeks mom returned to work as a high school teacher. Her husband was a
>college student at this time. Mom had little to no time to pump while
>teaching during the day. The baby was breastfed and formula bottle fed until
>9 weeks when all breast feeding was discontinued. Mom did notice or perceive
>a difference in milk supply on less stressful days, when her day was easier
>and husband didn't have papers or other excessive college work. Mom at no
>time felt any significant fullness in her breasts.

Well, no, that is exactly what you would expect with this history - it is
such a shame mothers have to go back to work so *crazily soon* - that is
not my value judgement, but a fact. It is crazy - though I am aware that
some mothers do not have a choice. It is still crazy. Does she have to go
back to work so soon with this baby as well?

>I've discussed some ideas for this coming baby with mom. I think the most
>important will be the fact there is now an on site day care at the school
>and mom can go there and breastfeed the baby between classes twice a day.

That's bouind to help, I agree.


>Breastfeed ASAP after birth and room in.

 Bed-in? If not possible (why not?) can the rooming in be real rooming in,
with any observations etc done at the bedside?

>Consider pumping on day 2 to increase supply.

Well, my feeling is this would not be necessary if everything is fine and
the baby is not separated from mum.

I know you do things differently in the US, but in the UK we would not
pump/express for a healthy term newborn feeding normally on day 2 (or at
any time in the early days). It would be regarded as intrusive and
'messing about' with the breastfeeding - better to leave it to the mother
and baby to enjoy getting to know each other and taking pleasure from
breastfeeding.

I would be interested to hear other views on this.

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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