Dear ones,

I have a first time mom who is not producing adequate amounts of milk.  She
delivered on 12/18; baby girl who weighed 5-7.  C/Sec for FTP.  Baby started
in ICN for observation because she was 36 weeks gestation, but came out in
about 36 hours.  Mom started pumping right away, but wasn't getting much of
anything.  (Of course, she was single pumping on the double setting -- do'h!)
Well, we got that straightened out, and she continued to pump, and put baby to
breast.  Baby would latch on, but do only brief, non-nutritive sucking bouts.
Tried the SNS in the hospital, and baby did quite well.

She went home, continued to try to use the SNS, but mom is very large busted,
and she just couldn't manage it, even with her husband's help.  Just didn't
work -- and when I saw her again, I couldn't get it on in the right spot --
not to mention baby fussed & cried a lot with the tube in place.  Breasts
point down a tad, and it was very frustrating for mom (and me too, at that
point -- I've used the SNS ever since it came out -- first the big one and
then the little one, and I've never had the difficulty I did with this mom and
the SNS....ARGH!)  Obviously she wasn't going to go home and work with it
since we both had so many problems.

Well, it was evident that that wasn't going to work -- she's still pumping,
putting baby to breast (who is only comfort sucking).  Mom still pumping --
getting 40 cc each pumping session.

On 12/29 -- she's still pumping, now down to 35 cc per pumping (she's single
pumping because double is just too difficult for her to manage with her large
breasts (46H).  Started on Fenugreek & Blessed Thistle.  By 1/5 up to 55 cc
per pumping -- she's feeling pretty good about this -- still putting baby to
breast -- occasionally gets good, nutritive sucking bouts of maybe 10 to 12
sucks per feed with a tad of swallowing.  One pumping got 70 cc.  Baby cries a
lot in the evenings -- to cut out all cheese and grape juice,  (both of which
she craved during pregnancy and now) and prenatal vitamins.

1/8 -- mom is now only getting 40 cc during a pumping.  Still using Lactina.
Suggested maybe classic would be better.  She says she never had normal
menstrual cycles -- has been married 10 1/2 years, but always used protection
(diaphragm) except one time -- which produced this baby....surprise.  So we
don't know if there was any infertility.  She's a large lady, but not
enormous.  Gained 10 1/2 pounds during pregnancy.  Low cholesterol, blood
sugars normal.  Went from about a 40 D to 46H in bra size.  Is not hungry, but
is forcing herself to eat.  She will get a very few "good" breastfeeding
sessions with some nutritive suck and swallowing, but lasting a short period
of time.  Obviously the flow isn't there to keep baby going.

She's going to get some Reglan -- I discussed that with her.  She's pumping
for about 12 to 15 minutes each side, 8 to 10 x/24 hours.

Thoughts?

Jan Barger -- where this January is one of the sunniest (if coldest &
snowiest) I've been in.