hi esti
go back to the basics with this mom. if she is to have any chance of a good
milk supply she needs to express very regularly. galactagogues can be used
but the expressing needs to be done. you were right to suggest expressing
and skin to skin. also feed the baby in the meantime of course. the mom
could feed the baby with a supply line or supplementer, the baby might not
shut down if there was a milk flow. the 10cc's of yield is not unexpected as
it sounds that there was very little nursing and/or expressing til 1 wk
postpartum and then after that mom sounds not to be doing it regularly. so i
wouldn't jump to a conclusion that this is a mom who won't have milk, it is
the lack of milk removal that is more than likely to be the cause.
if mother does not want to continue this plan or wants to offer the breast
for comfort that is her choice of course. i would not be the one to suggest
to her that she should not bf or cannot bf. even if she does not get a full
milk supply she can bf to whatever extent possible. i once said in class
that virtually all moms can bf, except double mastectomies. however if mom
got reconstruction she could bf with supply line. in other words, keep
encouraging this mom until SHE clearly gives the signal that she does not
want any more help.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA


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