I have a mom with supply problems who has been pumping q3 and using
fenugreek for about a week with a sl increase but not much.  Talked to the doc
and she gave a rx for Reglan x2 weeks including a one week taper.  Mom has
been on it for three days and thinks she has seen a little more improvement
and is supposed to call me back tomorrow and let me know how it's going.
      EBL was 350. Mom got engorged on day 3  and lochia has almost
disappeared.  Baby was sleepy and got a lot of bottles early on.  No
surgeries, no meds or hormones, non-smoker.  Mom is probably not getting
enough rest but looks okay, not exhausted.  We worked on latch--it had been
pretty shallow esp on the left--got a better latch and used breast
compression.  Baby does a few (2-3) deep sucks and then switches to non-
nutritive sucking.  I saw maybe 8-9 good sucks in a 20 minute feed.  Baby is
still very sleepy at the breast.  (i.e. maintains suction but very little to
none jaw excursion.)  Mom had been using a Playtex nipple for supplementation
and has now switched to the Avent. (I gave Mom a tube and syringe set up but
she prefers bottle feeding when she has company over or goes out) The doc has
written a referral for an OT consult for suck training but it may be a while
before Mom gets in for the appt.
     Does anybody have any ideas how to get this kid to use jaw compression?
Anything else we can try for the supply side? Baby is 5.5 weeks now.

     TIA

     Cindy Neary RN
      Lakewood, WA