Baby had a tight frenulum, and a bunched up tounge.
>Mom could not even tolorate baby latching on.

Was the frenulum clipped? This isn't the supply problem, but it certainly
needs to be resolved.

  Today mom
>calls me and tells me that her supply has dropped, dramtically.  Down from
>4-6 oz on a side, to 1-2 oz. total out of both sides.

 Mom told me later in the
>conversation that she has been smoking a pack and a half of cigerrets (sp)
>since day 4 or 5.  Can anyone help me think of any reason why she would
>lose her milk supply all of the sudden?

Nicotine reduces milk supply, and 30 cigarettes a day is most likely the
cause of her sudden supply drop.  There are also adverse effects on the
infant. Lawrence in *Breastfeeding, A Guide for the Medical Profession* and
*The Breastfeeding Answer Book*, by Mohrbacher and Stock both address this
issue, as does Tom Hale in *Medications and Mother's Milk*.

Every mother whom I have worked with who smoked has had a supply problem.
Some have greatly reduced their cigarette use and some have had to
supplement or stop breastfeeding.

I hope she wants to breastfeed enough to either stop smoking or to greatly
reduce it.

Patricia Gima,IBCLC
Milwaukee

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