Nicola
I have worked with moms in this situation. Here is what I would do:
Praise and encourage her and give her messages that yes, this is absolutely 
do-able and will be the very best for her baby. Let the baby suckle as much 
as possible and LOTS OF SKIN TO SKIN and holding. However, realize that the 
baby is inexperienced w/ bf and also a 35 wk'er, probably had lots of 
maternal-infant separation. Therefore, make sure the baby is well-fed (if 
baby and mother used to bottlefeeding I would stick w/ this) but change to 
paced bottle feeding w/ slow flow nipple if baby gains on this. Protect milk 
supply by doing frequent pumping w/ good quality pump, like a rental. Begin 
replacing artificial milk feeds w/ ebm that is now available.
Let mother know that bringing back in supply sometimes happens very quickly 
but sometimes takes a couple weeks. I use the analogy of pumping up muscles 
('pumping iron"). For example, I say if I try to build up my biceps muscles 
it won't happen on the first work out. But if I stick with it I will see the 
results.
I personally would not be quick to use the galactagogues in this situation 
(good potential for complete relactation) because it seems mothers begin 
thinking the drug will do the trick when it really is the emptying of the 
breasts frequently that does the trick. Also the cost may be high for the 
medication or herbal galactagogues.

Laurie Wheeler, IBCLC, MN, RN
Tupelo Mississippi, s.e. USA

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