I've been anxiously awaiting responses from an earlier post re: postpartum
mom with previous partial removal of the pituitary gland. So far no replies
with anyone else having had a mom with a  similar experience. Again this mom
takes cortisone and thyroid replacement therapy and got pregnant by IVF.  We
are were at 72 hrs. post C/D this AM. Baby with 2 stools last 24 hours -
only one void. Baby down 11% from birth weight - although I heard early
swallowing the first day, the breasts now are very soft with no signs of
fullness and no audible swallowing, not even a drop of colostrum with manual
expression. Mom is noticing some slight cramping with nursing. The
Pediatrician was comfortable waiting another 24 hrs, I wasn't. So far baby
is fairly content....but....now I've become more and more skeptical of the
outcome. I suggested initiating about 4 oz total of supp today and the
syringe at breast worked just so wonderfully for this baby who is just a
pretty little girl, very much doing her part to make it happen.

How long should I proceed until we say it isn't going to happen for this
mother and baby? I would love to have prolactin levels drawn to see effects
of the nursing and for baseline - does anyone do the triple prolactin levels
any more that are discussed in The Lactation Consultant Series on I believe
it is poor weight gain in breastfed babies? I've discussed additonal
pumping, but feel the baby is just totallly doing her part to bring the milk
in. Any suggestions would be welcome.

TIA,
LuAnn Smith RN, BSN IBCLC
York, PA








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