Donna
I think you are right on track with this dyad. Agree that the blood loss may
be playing a part, esp in light of no "milk surge" during first few days
postpartum. But there are also many confounding negative factors: long
separation of mom and baby w/ bottle feedings as first several feeds, ? poor
latch as indicated by blisters, I;m assuming a delay in starting regular
effective milk removal, use of probably a suboptimal pump, and very
infrequent milk expression.
In any case, your recommendations are appropriate. These cases really need
lots of mom/baby contact (re just about continuous) and lots of support to
continue. Are there other sibs to care for? As for the blood loss, unless
there is retained placenta (check w/ ultrasound?) there is nothing to be
done now except the things you've already suggested. Good luck to all.

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

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