I have a pt. I am working with and I am really worried about her.  When
I saw her and her baby he was more than 10 % below birth weight at 6
days old.  It sounds like her milk came in, he wasn't latching well and
she wasn't pumping and by the time I saw her she had virtually no milk.
Baby wouldn't nurse very well, lots of arching and pretty seriously
retracted tongue.  I told her to start taking Fenugreek and More Milk
and pump regularly and supplement  with formula.  He is now nursing
better, milk supply has increased minimally and he gained 8 oz in 3
days.  This Mom doesn't have a lot of support (Dad says it makes him
nervous to bottlefeed the baby because he can't burp him).  So Mom is
breastfeeding, bottlefeeding and pumping about 7 times a day (I know she
should be doing it more frequently, but I gave her those instructions
once and I honestly feel she''s doing the best she can).  She is very
overwhelmed.

My questions are :  Any other suggestions for increasing milk supply?
Any suggestions for emotional support?

I want to put her in touch with someone from LLL, but I want to talk to
them first because she doesn't want to talk to someone who is going to
criticize her for using formula.  She said she wants to breastfeed and I
believe her, and I think she just needs to talk to someone else who had
similar problems.

I did suggest trying the SNS so she can at least skip the bottlefeeding
part.  She said she had minimal breast changes (increase of a cup size)
during pregnancy.  I am worried about how successful she'll be in
getting her milk back, especially when I don't even know how much she
had to start with.

Any words of wisdom?

Andrea Tran RN, IBCLC
Boulder, Colorado

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