I have been reading for a few months and this is my first time posting so
let me introduce myself: I am a registered nurse, inpatient obstetrics
certified, masters degree in perinatal nursing, over 6000 hours lactation
consulting time, but poor prioritization on my part has not enabled me to
take the ILBCE yet. Until the last few years, my experience working with bf
moms/babes past the first week was limited. This brings me to my reason for
posting.
Pamela writes:
"I'm convinced that the first week - 10 days after delivery are really
critical to establishing adequate lactation, and it's usually in this time
that the breasts have the potential to become overfull or engorged, with the
sequel of lactation failure if this is not addressed."
I now do the same. I have a 14 month old. When he was born I thought I had
a bf champ. He fed ~20 min ea side every 2 hours. Then at day 8 he had lost
more than 10% wt; bili level in the mid 20s, stooling infrequently (I had
been arguing with the ped about this-he said "normal" and made me feel like
an over-reactive new mom)... I agreed to supplement w/abm to bring up his
weight and bring down his bili-of course I would only do that with SNS. To
make a long story shorter, my son was flutter sucking and I (and my LC)
didn't catch it. Unfortunately, I had engorgement day 3-4, and my flutter
sucking son could never stimulate my supply up to the level needed. At 6
weeks he was up to 8 pounds (from low of 5#-13oz) He still ate every 2
hours, it took him 1.5 hours every feed, only sucking strongly with the SNS
going, and then I double pumped 10 min with m-----a classic producing less
than one ounce combined. (I had 10-15 minutes every 2 hours to shower or
eat or whatever) I had to supplement with the SNS for 6 months as he slowly
gained wt, and could not pump enough out for him to get only bm while at
daycare (4-6 ounces total pumped while working 9 hrs). I tried fennugreek
and blessed thistle for months. A 2 week run of Reglan helped a little,
but not much. I stopped the SNS when he took enough food to make up for the
decreased supply, though he still had to get some abm at daycare. Bottom
line, I let moms know about the option to pump early on for babies that
aren't very aggressive feeders, take most of their feed from one side, or if
mom just wants to build up her supply in anticipation of returning to work.
Judy, RNC, MSN, CLC
Still breastfeeding in Phoenix, AZ (sorry for the long post)
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