What came first, the chicken or the egg?

I think the slow start at bf and the supplementation led to low milk
supply which I believe leads to slow letdown. This evidenced by "put to
breast 4 hours after birth; thereafter fed 4 to 6 hourly while in
hospital; sleepy first week at home w/ weight gain 50g.  Mother told to
supplement with formula." Subsequent weight gain was good but with 6 oz
formula per day.

The interventions of skin-to-skin contact and week-end in bed feeding ad
lib were good but mom still giving "occasional bottle when baby became
frustrated at the breast." It sounds like the regular milk expression to
increase supply came later. So the interventions now need to be
everything to maximize milk supply (use as much ebm as supplement if
needed, try nursing supplementer to supp. at the breast, don't forget
breast compression). I think the letdowns will come after that.

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