got a call and would like your further collective input. have not seen this
dyad though.
mother calls stating her milk supply is dropping. she is excl. bf a 3 mo old
approx 12 lbs now, from b.wt about 8 lbs, no solids, no formula nor water
etc. has not had return of menses yet, altho is having unprotected
intercourse. she works nite shift full time. she pumps x2 during the 12 hr
shift (7p-7a). baby goes to bed at 9pm and gets a bottle of ebm from dad
while she pumps at that time at work. she pumps again about 1 am while baby
sleeps thru nite. states she usually gets 16 oz total from these 2
expressions. now gets only about 1/2 that. she returns in am and feeds baby
as he awakens. she is there all day and feeds baby on demand. she is
somewhat overwt. and has not lost wt. she is on no meds. she uses "pump in
style" medela pump. she is sure pump is working fine. no signs of illness in
self or baby, no low thyroid s/s.
recommend r/o pregnancy, r/o hypothyroid, add breast massage and br.
compression, offered herb and prescription galactagogue info, suggest
possibly changing pump flange as breast changes may make this flange not
"fit" as well as before. i believe long term pumping like this can lead to
decrease when baby is not the driving factor in milk supply but an arbitrary
pump is. could it be that prolactin levels are low due to nite shift even
tho she pumps x2. did not really get to explore her sleep patterns but said
maybe she needs more rest.
what else? thanx for any ideas.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, se USA



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