A woman I know from an attachment parenting list is pregnant with her
second child. Baby #2 is due to arrive in two months -- when her first
child will be only 13 months old (!) -- but mom went into labor prematurely
and has been placed on bedrest.

Anyway, she had many problems attempting to BF her daughter, and eventually
used formula (after the hospital's LC told her she had insufficient milk).
When she joined the list, several of us gave her more information to help
her attempt relactation, but her efforts were, unfortunately, not
successful. This has been especially devastating because her first child
shows signs of being highly allergic. She has been sick most of her life,
including chronic ear infections and plenty of colds. (She is also very
small and was suspected of being FTT, although this was found not to be the
case.)

This mom is hoping to BF successfully this time around, but is afraid that
she is, as the LC told her, "one of the 10% of women who truly can't
breastfeed." :P Below are the details on her experience -- perhaps you can
give your impressions on whether 1) she has reason to hope for a positive
outcome this time; 2) this really sounds like insufficient milk (I don't
think so -- there is clearly some mismanagement here); and 3) there are any
tests she can have done now to look for physical abnormalities. She is in
the Denver area -- please email me if you know of any top-notch, pro-BF LCs
nearby.

****
Baby #1 was born by c-section (at 39 weeks, 6 lbs., 6 oz.) and put to the
breast within 30 minutes. (She recovered very well from the c-sec and
doesn't consider this a factor per se in the problems with nursing.
However, she *did* have an epidural and, six hours before the birth, a full
dose of Nubain. ).

During the four days at the hospital, mom nursed her on demand, although
sometimes the baby would go four or five hours without nursing -- obviously
a recipe for low supply. While in the hospital, she awakened to nurse
usually just once per night. When baby did nurse, mom let her nurse as long
as she wanted -- anywhere from a couple of minutes to an hour, usually
15-30 minutes. The baby slept a LOT as a newborn. This pattern continued
when they got home. Mom thinks the baby was given a pacifier in the
hospital, and knows for a fact that she was once given glucose and once
given formula without mom's consent. In retrospect, mom thinks baby had a
very weak suck. "I couldn't tell if her latch-on was correct or not. It
didn't hurt, but she didn't seem to be getting enough to eat." As for
engorgement, mom says she had "some engorgement -- it just wasn't
comparable to what all the books talk about. For example, if I would go for
longer than four hours without pumping or nursing, I would get hard,
slightly sore breasts that began to leak. Is this engorgement? It didn't
hurt very much." Mom doesn't remember seeing any obvious signs of
swallowing in the baby, but wasn't looking for them either.

Baby had about 6 to 10 wet diapers a day, and the urine appeared normal to
mom: "Light yellow, sometimes clear. When she was first born she had some
rust-colored staining for a week or so in her wet diapers." As for bowel
movements, "Anywhere from one to five poops a day; I supplemented so early
on, though. They were characteristic of breastfed poops--yellow, mustard
seedy, smelled not bad. The green coloring didn't start until she was
exclusively formula-fed and that was from the iron."

The second night they were home, the baby cried all night. Mom would nurse
her
and she would fall asleep and then wake up minutes later. The LC said to
give
her formula using the Pl*yt*x nurser -- SNS, cups, medicine droppers, etc.
were not mentioned. Well, mom did, and the baby did seem to be hungry.
"This is the one time that she did suck very vigorously. Poor little
girl...she was so hungry," says mom. Mom kept supplementing with formula
and baby was getting used to the bottle. Mom started pumping every two
hours (the LC told her that a M***la Lactina is a hospital grade pump).

By three weeks, the baby completely rejected the breast and mom attempted
to give her EBM exclusively; however, mom was only able to pump out 4 to 6
ounces per 24-hour period). During the fourth week she decided that she
couldn't do it anymore. In her words, "The LC was NOT helpful and offered
the lame excuse, 'Oh, you must be one of the 10% of women who TRULY can't
breastfeed.' Note: This is the woman who gave me a 'breastfeeding support
bag' with formula in it."

Then 10 days later, after she got onto the AP list, she tried to relactate.
She never made any more milk. She had another LC who she felt was very
knowledgeable and she tried Fenugreek, Domperidone (a lactation-inducing
drug from Canada), Mother's Milk Tea and pumping pumping pumping. She
finallly gave up, because she wasn't producing more than four to five
*drops* of milk per pumping session. She had PPD for about 10 days after
the baby was born and she couldn't eat or drink much. "I could hardly
function, I was so down." She was not caffeine-free.

She also used the M***la classic and an Eg**ll pump, as well as the
Lactina. She adds, "Oh, I also had to hand express the milk WHILE pumping
with a hospital-grade pump. I really had to push that milk out of the
breast, and that thing could SUCK. I never had any let down that I knew of.
I'm very, very scared that there is something wrong with the shape of my
breasts, which admittedly are heading south quickly, and that they will be
hard for the baby to get any milk out of." Mom is overweight and has very
large breasts.

Mom had wondered if pumping before Baby #2's birth would help, but this was
before she went into premature labor. She plans to go to the hospital with
a pump this time, to wake the baby (depending on his disposition) every few
hours, and to pump a bit after each feeding.

Some other details:
- I asked whether the LC checked baby's suck and the structure of her
mouth, chin, and tongue, and mom replied, "She came in, poked the titty,
said we were fine and gave me the lovely bag of treats from Ross
Pharmaceuticals."
- Mom was not tested for hypothyroidism or diabetes. Her hormones weren't
checked.
- Mom didn't smoke.
- Meds mom was taking in the first two weeks: All the induction meds, the
epidural meds, painkillers (Percocet) until she got home. Then just tylenol
as needed.
- Mom says that during pregnancy and after the birth, her  breasts didn't
get really big. They were both the same size. She has had much more breast
increase with this second pregnancy.

Sorry this is so long, but I wanted to provide every detail I had --
anything that might help. TIA for any thoughts you have.

Janice Berry
Columbus, OH