Dear Colleagues,
I have a patient 6wks pp. delayed lactogensis, by 10days pp before colostrum coming in and then beginning to see milk. Not an extensive long labor. Epidural anesthesia, states she is a tense individual. Well, developed breasts with some but not alot of growth during pregnancy. upper 30's in age and primip. Baby boy, mom is Asian and states that Asian women have delayed onset of lactation. First one for me most Asian women I assisted had milk in by day 3. Baby was nursing, and mom pumping while in hospital and after discharge. baby needed nipple shield to latch well. Not a great nurser, used supplementation with SNS once weight dropped 10%.
Initial ped visit baby gaining but mom also supplementing. 5 wk check up baby below birth wt at 5# 15 oz.  Ped had mom pump and bottle feed. Baby gained 3 ounces by next day. Mom has been taking fenugreek, also MMT up to 3 x day. 
Spoke with her on Friday, her period has resumed. I talked with her about calling her OB for Reglan. Since she has the tenseness she was concerned about depression. I told her she could ask about Domperidone, she does not have a history of seizures. Our OB's aren't really great about prescribing Domperidone because it isn't FDA approved even trhough a compound pharmacy. 
Mom will pump forever and also looks at breastmilk as innoculations for baby. I really want to help her but need your assistance. Our docs aren't great about ordering hormone levels, they feel that you are going to treat them anyway if they are low so why put the patient through it.
Please feel free to email me at [log in to unmask]
Peace,
Terri Klein Rn, IBCLC, RLC

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