>In the past week I have had two instances of a situation I have not 
>come across before, where a mother and baby who seemed to be feeding 
>well and getting bf established effectively reported signs that 
>there was a sudden and dramatic drop in milk production. In the 
>forst case, the baby did have tongue tie and the mother was waiting 
>for a referral, but the baby showed signs of feeding well, and the 
>mother had also been expressing - although it was a manual pump that 
>was not esp effective. I saw her one day and helped with getting her 
>and the baby more comfortable, and watched him feeding in a couple 
>of positions. she was also expressing a reasonable amount of milk as 
>she had been giving that and formula because he had not been 
>attaching or sustaining feeds well. Next day she called very 
>distressed as the baby was not satisfied, and she was not managing 
>to get more than a few drops. I visited and saw that the baby was 
>indeed no longer swallowing. I took an electric pump and she started 
>expressing more often.



You don't say how old that baby was, but I am guessing quite young? 
If she has been giving even a small amount of formula over a period 
of time, and if she was not breastfeeding often, then it is possible 
she has hit a crisis of production. But it could also be the case 
that her expressing was just not effective, but feeding direct was 
ok. 'The baby not satisfied' can mean *ANYTHING* :) :)

It can mean the baby is not attaching well (possibly to do with the 
tongue tie you say the baby is getting fixed). It can mean the mother 
believes the baby should be finished his feeding session after 2 
breasts or after some arbitrary time limit. It can mean the baby does 
not stay asleep for long. It can mean the baby is grouchy and fussy 
for some other reason. So more info needed, I think :)

Weight gain, stools, pacifier use....all relevant, too, of course.

>The second case was a mother who I had been supporting from day 2, 
>and had seen her establish bf slowly but well, also called me this 
>morning to say breasts no longer dripping (now day 10) and baby very 
>unhappy and screaming at the breast, and not sustaining effective 
>feeds since yesterday. She has now gone to get baby checked at 
>doctor's to rule out illness, but the sudden overnight change in 
>signs of good production again is bizarre?


Not dripping at day 10 is well within normal. Impossible to guage 
what is happening with the milk supply - the baby's stools will help 
with clues, and so will the baby's weight.  Perfectly good idea to 
get the baby checked out medically.

If there *is* a real  drop in production, was the baby feeding 
frequently day and night?  Had the mother been supplementing? Was she 
using a pacifier? What has weight been like?

There is always a reason for sudden production loss....and sometimes 
it is only apparent, not real.

Hope this helps.

Heather Welford Neil
NCT bfc, tutor, UK

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