My name is Paul Pfennig and I am a nursing student at the University of
North Dakota.  I have a client as part of our family community nursing who
has a premature baby.  She expressed an interest in breastfeeding and I
hope to be able to make this decision possible.  She pumped every four
hours for 1 week after the baby was born.  She quit due to time constaints
and work conflicts.  The baby is currently in the NICU and doing fine.

I recently talked with her about the possibility of starting pumping again
to be able to breastfeed.  She expressed an interest in starting again, so
I started talking with lactation experts at the hospital.

Convinience is a concern for this mother, although she expresses
understanding that relactation may take some effort.  Literature suggests
use of a double electric pump, as this will decrease the total amount of
time to express milk  (Groh-Wargo et al., 1995).

The mother also expects that the total volume of milk expressed will not
be enough to feed the baby and anticipates supplementing with formula.
Thompson (1996) talks about how when the mother holds the infant skin to
skin, the mother was able to pump more milk after each session of holding
the infant next to the breast.  Mohrbacher and Stock (1997) write about
certain medications that will allow increase milk supply, mainly Reglan.

My questions are:

1.  Are there any other nonpharmacological means of increasing milk
supply?
2.  What experience is there with the use of Reglan and increased milk
supply?
3.  Any other suggestion for this situation?

I thank you for your time and consideration

Paul Pfennig
University of North Dakota



References

        Groh-Wargo, S., Toth, A., Mahoney, K., Simonian, S., Wasser, T., &
Rose, S.  (1995).  The Utiltiy of bilateral breast pumping system for
mother of premature infants. Journal of Neonatal Nursing, 14(8):31-6.

        Mohrbacher, N., & Stock, J.  (1997).  The Breastfeeding Answer
Book. (2nd ed., p. 334). Schaumburg, IL: La Leche League International.

        Thompson, N. M. (1996). Relactaion in a newborn intensive care
setting.  Journal of Human Lactation, 12(3), 233-5.