Most moms with reductions do need to supplement, but many make
surprising amounts of milk given the right stimulation.  Sometimes I
recommend "super pumping" for moms with very low milk supplies and
non-latching babies.  Super pumping means setting up the pump in a
convenient area, and using it everytime she passes it, say 5 mins or so
out of every 45-90 minutes.  This pushes up her prolactin level, and can
be really helpful.  To make it feasible, I recommend she cover the pump
kit with a clean towel between uses, and clean it (the kit) every 4
hours or so.  If the baby is medically fragile, this might not be good
advice, and you might want to supply the mom with several kits instead,
so she can change them and then wash them all at once.

Once she gets the baby to breast with a lact-aid or sns, she will
probably get more milk.  How much milk is enough is up to her.  You are
not promising her a full supply, but there is hope she will make more
with more intensive stimulation, if she can manage that.  She can also
try goat's rue, it's a tip I got from Lisa Marasco, and  some of my
clients think it has been helpful.  Domperidone is another alternative,
again, depending on the baby's condition.

--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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