Got a call just before I left work today from a very upset young mom.  She delivered a 34 week baby a month ago.  Baby has been in special care, came home from the hospital over the weekend. She has been pumping and for the past two weeks in the hospital, exclusively nursing.  Baby latching and gaining well, lots of output.  Mom had lots of milk, twice a day still needed to pump because of fullness.  Says she is from a long line of breastfeeders, nobody in her family has ever had formula.
Yesterday at 6 AM, she nursed and he guzzled down the milk.  At 9, when she went to nurse, her breasts felt looser, and baby was not content after nursing. She nursed him all day yesterday but he was not swallowing. No wet diapers or bowel movements.  Last night she gave him some formula, and has been giving him formula today, plus nursing.  She hears no swallowing when he nurses, and when she pumps with her double pump, she gets nary a drop.  She denies any changes in her diet, no hormonal birth control, has not been ill,eats and drinks well, no lifestyle changes. She is devastated.  I encouraged her to keep nursing, try some herbs such as fenugreek and blessed thistle,and supplement as needed to keep the baby hydrated.  Suggested relaxation techniques, skin to skin, frequent nursings.  What do you think is going on?  I told her to call me tomorrow morning early and would like to have suggestions for her if she is still not getting any milk.  Says her breasts are not full, no leaking, nothing. She cannot hand express a drop either.
Help?
Ann Calandro, RNC, IBCLC

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