Robin writes:

>Looking for any suggestion to help this mother. Hx PCOS, extensive 
>fertility work-up and told she'd not have babies and lo and behold 
>she  has a handsome little son. Baby is >now 11 weeks and mother 
>feels is fussy and demands to nurse a lot but will fall asleep at 
>breast. At birth milk came in, infant nursed adequately, weight gain 
>was good. At >about 4-5 weeks mother notices infant went from 
>nursing 1 hour to 10-15 minutes, usually every 2 hours. Infant just 
>seemed not satisfied.

This change in pattern and routine is within normal - it is on the 
normal spectrum for a baby to have short, frequent feeds.  The 
mother's perception that he was not satisifed.....why was this? If it 
was just that his pattern had changed, it does not mean there is 
anything wrong.

  >If mother pumps gets 3oz >total from both breasts combined. Has 
tried varied pumping regimes, pumping 5 min 3 times in a row; also 
pumping after feeds. When mother >perceived infant not 
satisfied >started supplementing formula prn. Has taken metformin 
500mg BID, also Mother Love More Milk Special Blend, eating lactation 
cookies, >drinking mothers milk tea. >Infant does have labial tie 
which mother is considering having evaluated, no lingual tie and 
adequate movement of tongue. Recent labs show a low >T3, but T4 and 
TSH are >normal; high baseline Prolactin. Mother has had some 
spotting and notices milk supply down on those days. Pre and post 
feeding weights show >transfer 2-3ounces. These >parents are foster 
parents of 2 high needs little girls, I feel stress plays in all of 
this. Any suggestions for this mother?

What is the baby's weight?

It sounds like this mother is doing *so* *many* *things* and has had 
*so* *many* investigations....pumping, all the hormonal stuff, trying 
to observe if spotting coincides with a drop in supply, the 
medication and the tea.......WOW. And now supplementing with formula 
:( :(

Back to basics, maybe?

Crucial to know the baby's weight and the history of the weight gain, 
and *why* she thought the baby was not satisfied, IMO.

Heather Welford Neil
NCT bfc, UK

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