This is the first time I have posted so I will quickly introduce myself. I
am an Australian LC and midwife currently on maternity leave having had my
first baby a month ago. I am thoroughly enjoying motherhood, breastfeeding
and the time I now have to keep up with Lactnet posts.
I am seeking your collective wisdom in regard to a near desperate situation
with a breastfeeding friend who seems to have tried it all for a low milk
supply.
Baby is 8 weeks old and current weight is 4170gms, birth weight was 3580gms.
It took baby 4 weeks to get back to her birth weight. Baby has had normal
growth in her length and head circumference. Baby is alert, has reasonable
urine output and bowel motions.
Mother currently breastfeeds every 2 hours during the day and every 3 - 4
hours over night. Baby feeds for 15 - 20 minutes on both breasts,  and suck
swallow ratios indicate let down takes place.(Mother also feels let downs).
A pacifier and a baby sling has been used to give this family a break but
perhaps to the detriment of mother's milk supply. Baby has received
occasional formula supplement given via a supply line (nursing supplementer)
when no weight was gained. Mother has also expressed post breastfeeds using
an electric pump with duel collection units. Mother has had two episodes of
sore nipples but baby appears to have a good latch. It is this mother's
first baby and she had a normal birth, with complete placenta without drugs
at term and breastfed straight after the birth. Mother has no medical
illness and has not had any breast surgery. She did not increase her bra
size throughout her pregnancy and there has not been much areola enlargement
however she certainly experienced fullness when her milk came in. She is
currently taking Domperidone 10mg x 2 three times a day, Fennelgreek 500mg x
2 three times a day and St. Mary's Thistle 70mg x 2 three times a day. Today
she told me the baby has developed thrush around it's bottom which she is
treating with an antifungal. She will also treat herself as a preventative
measure.
This family has just about had enough and I don't know what else to suggest.
I am wondering whether baby has an underlying medical condition ( i.e.
urinary tract infection) which is compounding the problem. I would be
extremely grateful for any new ideas for this extremely motivated mother.

Anne Bond, RN, RM, IBCLC
Melbourne, Australia


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