Hi Lactnetters,
I'm feeling frustrated and could use some suggestions, I'm not sure which
track to take next. I have been working with a mom(mostly long distance)
for nearly four months. Brief history - Mom had very bad birth experience
(4th degree tear) and was in terrilbe pain after birth(couldn't sit down
comfortably). Add to this pain a baby who was tongue-tied and chomped.
Moms nipples were "bloody stubs" for day 3. I took her a rental pump and
she began pumping on day 4. Also started on Alfalfa and fenugreek. Milk
production was very slow to come in, but this mom kept up a rigid pumping
schedule, even though pumping was painful. On day 12 she had blood work
for thyroid, anemia, prolactin, etc(everything I could think of), and all
was normal. She kept offering breast, but the baby would chomp and not
suck, so they finally went to a bottle in order to "feed the baby". Baby
prefered bottle for about 6 weeks. Pumping continued to be very painfulf
for mom, but she kept it up every 2 to 4 hours around the clock. Then I
figured out that she had thrush. Finally after 10 days of Diflucan pumping
was not as painful, however milk supply was still low. She tried Goat's Rue
and More Milk Plus before the yeast. Both helped some, but she never got a
full supply(How big a factor was the constant pain?). At two months we
started an SNS in order to try to get the baby off the bottle and back to
the breast, as mom was finally pain free for the most part. Meanwhile mom
is still doing a lot of pumping. Baby took to the SNS and eventally
started refusing the bottle and prefering the breast. However, the only
time mom could feed her without the SNS was at the first feeding in the
morning. At three months we finally arranged to take her to New York to
see Cathy Genna and Dr.Coroylus (I had suspected a posterior tongue tie
since the begining). The sonogram showed that baby was indeed tongue tied,
and the frenulum was clipped. We also came up with a way to get her
domperidone to work around Dad's fear that purchasing a drug that wasn't
FDA approved would affect his security clearance for his job. She has been
on Domperidone for over a week, and hasn't seen much progress. Mom is
getting really frustrated and burnt out and ready to stop using SNS.
Currently she is able to just nurse first thing in the morning (7-8 a.m.)
and baby is content for 2-3 hours. Mom pumps about 3 ounces around 9a.m.,
at baby's next feedings throughout the day she uses the SNS and baby is
taking 1-3 ounces from the SNS. Baby sleeps all night (6-8 hours) and has
done so since 2 months. Mom has slowed pumping to only 2 or 3 other times
during the day. She had wanted to have breastmilk for the SNS, but was
never able to get enough. I suspect that it maybe too late for her to
develop a full supply at this point, but she and I would both like to
preserve some breastfeeding. So the big question - What to do at this
point?? Mom is really tired of staying home and being tied to the pump and
the SNS. Would you reccomend that she just nurse and stop the SNS, that
she stop pumping altogether, that she alternate breastfeeding and bottle
feeding to let her breasts fill up or what?? Would it be helpful to give
Goat's Rue and More Milk another try along with the domperidone? Anyone
ever see milk production come up after 4 months?
Peg Merrill, IBCLC, RLC
Baltimore, Md.
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