>Permission to post. I need to brainstorm with anybody who has any
>ideas.  This mother is a 29 y/o G2P2, now 2 weeks post scheduled
>C/S, with a history of successfully breastfeeding a previous baby
>for over 17 months.  She has no significant medical history, no
>medications,  only took motrin and colace after the C/S, and was
>able to latch baby in first few hours after the C/S.  There was a
>delay in lactogenesis, with dark stool "algae" green for most of the
>first week.


For whatever reason, this sounds like a slowish start to bf.

>Eventually it changed and now it is the color of dijon mustard, x4
>stool per day (at least), not tremendous in quantity, but each stool
>at least the size of an american quarter or larger.  His urine is
>clear.  His oral anatomy appears normal, no short tongue, palate is
>normal, can sustain a suckle well.  She had mildly sore nipples for
>the first week and that resolved.  She has been taking fenugreek for
>5 days now, 600 mg caps., 3 of them 3 times per day. She does not
>feel her milk supply has increased.  Her nutrition is good, she is
>drinking lots of water.


Her food and water intake are irrelevant, though (unless she is
drinking *vast* amounts which we  know can reduce milk production).


>
>  This baby weighed 3200g at birth and today, at 2 weeks 4 days,
>weighed 3000g.  Granted, they were different scales,


The difference in scales could be significant. Or perhaps the
birthweight was incorrectly recorded.  However, if both weights are
correct, it would indicate something unusual happening with the
baby's intake, I agree.

>  but he is nursing constantly


This has *always* got to be unpicked, in my experience. 'Constantly'
can mean different things to different mothers - it will never mean
*literally* constantly, so we need to know how often, if both breasts
are used.

Given that the most common cause of low weight gain in otherwise
normal babies is simply inadequate access to breastmilk (far, far
more common than a mother's underlying inability to make sufficient
milk), first step in my experience is to check how often the baby is
coming to the breast and how effectively he is feeding when he is
there (which can be assessed on observation).

So could it be his 'constant' feeding is actually not all that often,
let alone 'constant'?

Heather Welford Neil
NCT bfc, tutor UK

(reminded of 'Annie Hall' when Woody Allen is asked by his therapist,
off camera, 'how often do you make love?' and he answers, glumly,
'hardly ever....maybe twice a week.' The same question is asked of
Diane Keaton by her therapist, and she says, exasperatedly,
'Constantly! About twice a week.' )
--
http://www.heatherwelford.co.uk

http://heatherwelford.posterous.com

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome