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Subject:
From:
"Patricia Gima, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 8 Jul 1997 13:41:56 -0500
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1) young mom wants to breastfeed, hemoraged at the birth, low hemo. count,
low supply, ped said supplement with abm...He doesn't even see the baby
(nurse weighs her and reports) and he orders returning to supplementing 1-2
oz of abm at every feeding.

Update:
Mom decided to not give abm, but to try to get baby's weight up to doc's
charts by following week.  She was scared and unsure of herself.  After two
days her milk supply dropped and she began the abm.  I encouraged her to
return to fenugreek and More Milk, but she never called to follow through.
Friends told her that since she was to return to part-time work she would
probably have to supplement anyway, so what's the big deal.
_________________________________________________________
2) Mom presents with beginning yeast infection on nipples.  Goes to ped and
asks for treatment for yeast in her and baby.  Doc looks in baby's mouth,
says no thrush, won't treat...Mom is reluctant to go to a doc I refer to who
will treat yeast.

Update:
I talked with ped and he agreed to treat with Nystatin even though he
doesn't believe that yeast is "catching." Baby and mom can't pass it between
them.  Mom contacted her OB and got Diflucan.  OB is knowledgeable because
his wife had a persistent case of yeast overgrowth while b'feeding.  She's
not out of the woods yet.

______________________________________________________
3) Mom has low milk supply, having to supplement premie.  She is still
bleeding red after 5 weeks...prescribes an industrial strength antibiotic
which (you guessed it) can't be used with breastfeeding. Baby will have to
be totally abm fed for the 7 days of the treatment and 2 more days after.

Update
This mom took her antibiotic and fed abm for 9 days. Heavy bleeding resumed
and OB ordered a D&C, and (surprise) there  placental fragments. The day
after the procedure her breasts felt as if she had just given birth--heavy,
milk dripping, etc. But baby has been reluctant to return to the breast.
Still working...
________________________________________________________
More Milk "test case"

I told some of you of the mother of a 5-month-old who had b'fed for 3 weeks,
still had some milk, and wanted to relactate.  She had stopped b'feeding to
begin birth control pills, found she couldn't tolerate them, and wanted to
try to resume feeding her baby. She rented a good pump and began taking
fenugreek and More Milk on a Friday.  On Monday she called and was excited
that her breasts had grown heavy and larger on Saturday.  She was also
feeling a "tingling" when she pumped.  Her output had gone from one drop to
covering the bottom of the bottle.  On Tuesday she was continuing to
increase her milk and we made plans to work on Thursday with getting baby to
go to the breast.  She had been holding her skin to skin as much as she
could and baby was licking the nipple, but didn't know what it was all about.

Wednesday evening her husband had friends over for dinner which mom
prepared.  She had had no time to pump, and hubby was constantly telling her
that she was wasting her time and that she wouldn't make milk and the baby
would never nurse.  He didn't want her to mention it to his friends.  So she
didn't pump from Wednesday noon till Thursday A.M. She felt foolish for
trying to relactate.  On Thursday she was back to getting just a few drops.
We talked about her husband's influence on her resolve to continue to work
on her milk supply.  She was, for the first time, dejected about it all.
She didn't pump much over the weekend--not when he was in the house.  She
resumed on Monday and tried to boost her resolve, but never got more than a
few drops.  On the following Thursday she called and said that she would not
be working on it any more.

We talked about what she could do for her baby while bottle feeding
her--skin to skin, stroking, holding her close, switching to the other arm
half way through the feeding, etc.  She was glad to hear of something that
could make a difference.

I believe that the More Milk and fenugreek could have helped her bring in a
milk supply if she had had encouragement instead of opposition.

Fortunately these haven't been my only cases in the past few weeks. I deeply
admire women who can succeed in breastfeeding their babies in the face of so
much resistance. And I have compassion for the ones who can't.

Patricia Gima, IBCLC
Milwaukee








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