I would like to thank all of you that responded to my last post of 
frustration. I want to update you as to what is happening so far. I had an 
a client that was Asian. She was having many problems, breech presentation 
that meant cesearean delivery. Many pain issues and possible spinal 
headache. I had tried kangaroo care and for the three days I took care of 
her she would only feed the baby at breast a couple of times others were 
bottle feeding for her because she felt too ill to care for her baby. She 
did very little pumping. I felt that my efforts were all in vain. I had 
taken the husband aside and talked to him about pumping. Over that weekend 
she had a seizure. She was transferred to a much larger hospital. She went 
under neurological testing. Placed on antiseizure medication. She did 
continue to pump when she felt up to it. She was discharged home. Her 
husband went to a DME to obtain a PIS for her. I also offered a hospital 
grade pump for her to continue pumping until her milk supply was 
established. I haven't spoke with him this week but as of last week she 
was pumping and dumping because of the medication not safe for baby. I did 
get a clearance of 72 hours of pumping and dumping after her last dose 
from Dr. Hale. Her husband had an appointment this week with her 
neurologist and he was hoping she could be placed on Dilantin instead. She 
has not had any more seizures but still headaches. She has been taking 
Vicodin which has helped with pain issues. I hope to speak to him this 
week.
     My next client delivered prematurely and I can't even tell you many 
weeks because she delivered during the time I was off on medical leave. 
She had preclamsia. Baby never nursed while in NICU, does nurse very well 
but mom has a very low milk supply. Baby will nurse 20-30 min each side. 
Mom can only pump 30ml. I helped her with a SNS but it was too combersome.
I am having her use a Symphony. She is taking Reglan every 6 hrs but 
hasn't noticed much improvement. We are talking 3-4 months out. Would it 
benefit to have Prolactin levels drawn? She feels greatful for my support 
and she will let the baby nurse because they are both enjoying it. I told 
her that I feel that every drop of breastmilk is beneficial to her baby. 
She has pumped after feedings, she has pumped early mornings. Your 
suggestions are welcome. 
Fondly,
Terri Klein RN CLE CLC

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