I've been working with this mother and her baby since newborn and breastfeeding has been going on just fine for the both of them until 2 weeks ago when the mother suddenly mentioned that her right side breast was having an episode of plugged duct due to an ill fitting bra.

I've prepared a feeding plan for her to follow which consists of frequent feedings, lots skin-to-skin contact, babymoon, adequate intake of liquids and maintaining a healthy balanced meal. I've also thought her how to hand express and had suggested that she hand express right after every feed, especially on the affected (right side) side. This was done 5 days ago and until today, she has yet to be able to produce enough milk when pumped for her baby. She was able to pump 3oz from both breast prior to this. Her baby is now 1.5months old. The baby has already been fed some formula for several feedings as the mother claimed that the baby fusses and gets angry when she is being offered the right breast. My conclusion from this is that perhaps baby is fussing because of the missed fast flow, or there might be a change in the taste of milk (salty perhaps) due to the plugged duct episode.

The mother's concern is that she will be going back to work in 1 month time and she is worried that she wont be able to provide a storage of EBM for her baby and would need to supplement with formula. The mother is also worried about being able to sustain the feedings solely on her left breast as her baby feeds about 4oz and always seems to want to nurse after a bowel movement (which is totally normal in my opinion)

Upon examination of the mother's breast, I do not see any signs of hypoplasia, nipples are of standard sized, there are no history of any underlying maternal health conditions, no history of failed lactation in the family. The birth was natural and un-medicated and baby was able to regain back its birth weight by the 13th DOL.

Can anyone please advise me what am I missing out in my observation and how else can I help this mother? I am just not ready to just let her give up and wean her baby off as I believe that her condition can be addressed.

Thank you!
Moe Fletcher, CLEC

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