Fellow Lactnetters:
Am desperate for assistance with dedicated mom who has struggled off and on
with insufficient milk supply.Baby  girl born 4-3-00 at 7#4oz to 30 yr old
mom.  H/O 2 previous miscarriages at 6-8wks but this pregnancy uneventful
until 28 wks when BP elevated. Started on Normodyne for hypertension which
was continued until 4 wks pp when BP remained normal. Uncomplicated labor
and delivery except for epidural.
Nursed immediately after delivery and felt everything "fine" until baby
readmitted to hospital at 5 days with dehydration.I was called to see her
then, noted shallow latch which was easily fixed. Also somewhat delayed
onset of milk production which I attributed to ineffective latch and milk
transfer.  Next 6 weeks went well with good wt gain,happy baby. Mom started
on Micronor  at 6 wks. Called me at 8 wks with dramatic drop in milk supply.
Baby crying, fretful, pulling at breast. Obtaining scant milk when
double-pumped with hospital grade pump.(Had been using as needed with no
problems until then)When baby examined noted thrush which was treated with
Nystatin and resolved. Also started on Fenugreek with little improvement.
Started on Reglan for 2 wks with good results but within 5 days of last dose
milk supply down again. Dr ordered another round of Reglan, continued
Fenugreek, started Blessed Thistle. Thyroid level normal at that time.  Good
response again until 4-5 days from last Reglan dose--baby fussy, pulling at
breast, breasts soft. No signs of thrush. Mom discouraged-loves nursing and
planned to BF indefinitely. Gave her info on Domperidone including Dr.
Jack's hand-out.After reading and researching she was eager to try. Very BF
supportive OB faxed RX to Murray's Pharmacy in Canada(thank you Carol
Brussel!) and she took 2 4x/day for 7 days then tapered off. Great results
with no side effects, but took last dose 4 days ago. Just spoke with
her--baby very fussy, does not feel MER,breasts "flaccid". This started
today. Has always nursed baby whenever she acts hungry or in need of comfort
but is very discouraged. Did call to have Domperidone refilled but pharmacy
close until Monday. When baby 15 wks old started cereal to avoid ABM -- baby
very ready and does well. Has resorted to ABM only twice and has about 30 0z
frozen so will use until supply back up.  I know this is long but I am
running out of suggestions and am afraid I am missing something that could
help this very dedicated and determined mother. Does anyone have any ideas
to help or at least explain this chronic struggle with under-supply? Please
respond ASAP as this mom requested I post  and is waiting to hear.
TIA,
Jan Morton RN, IBCLC
Canton, Ohio

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