Michelle
I know you asked for more info on oxytocin spray for this mom, but I'm not
even going there. I get the feeling that the mom wants a quick fix. I could
be wrong, of course.
I noted you said she had a previous baby she always had to supplement. Why?
Primary problem or poor bf practices? How long and exclusive was her bf
(maybe not long because she has a 12 mo old too). I note that this baby is
preterm, born at 35 wks, right? and now at 4 wks weighs only 5 pounds. Just
reading this, this seems very small. Is mom a smoker? This could have
profound effects on supply, not to mention a premie small baby often needs
help keeping up a good intake and a good milk supply. Here is another case
that needs a more indepth evaluation and Michelle you are the one who can do
it! I agree with Heather (I think who said) that not much room in this
baby's daily intake for breastmilk if taking so much formula. I hope I'm not
sounding too judgemental but I fear the plan of care I would suggest to this
mom might not be what she was wanting to hear. I hope they can recover the
breastfeeding with your help.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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