This is an update to the post I made on 24 Aug about a mother of a 4 mo old
with an inadequate supply.  This is mom's typical day as of last Friday:

      Feeds every 2-3 hours with breast compression and supplements at
breast.  Each feeding consists of 3 minutes on 1st side with letdown and
infant eagerly sucking.  Baby stops sucking as flow stops and mom switches
to 2nd side for a repeat of good sucking for about 3 minutes.  Infant just
cries when flow stops.  Then mom adds supplementer and infant feeds for
20-25 minutes on1st breast while getting 20cc through tube. Mom states that
her daughter's suck is actually weaker with the supplementer though she
draws the fluid down (supplementer is syringe and feeding tube). Mom then
pumps 15 min and gets about 25 cc out of 2nd breast and a couple ccs  out of
the 1st.  Baby sleeps through the night (6-7 hours) and mom is trying to get
up and pump at least once (2 ounces).  Mom is a very deep sleeper and
declined cosleeping out of fear she would smother her daughter and not know
it (dad gets up for all night wakings and gets mom up to pump).  Mom notices
no improvement in supply since we added breast compression, the
supplementer, and hospital grade pump  (previously, mom was switch nursing
to keep sucking going, supplementing with ABM in a bottle, and pumping with
hand pump to meet baby's hunger needs/stimulate breasts).
       I spoke with her on Friday and continued with current plan because
over the previous 3 days her need to use ABM had decreased...hopefully this
means a subtle increase in BM.  By the way, she has been on fenugreek and
blessed thistle for 5 weeks with no change in supply.  The only suggestion I
received from Lactnetters was co-sleeping.  I see her tomorrow and if no
improvement, we will try Reglan and I am trying to convince her to try CST
(infant flutter sucks). Also, a week ago she developed unilateral breast
pain "2 fingers back from areola with no lump, redness or fever."   Anyone
have any advice I can share with her??? TIA

Judy :-)
Judith I Rosen, RNC, MSN, CLC

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