I've had a rotten day with more than my share of phone calls from women who 
"don't have enough milk." Several of them are only pumping/feeding/trying to 
feed about 3 times per day. One has gone back to work about a month ago and only 
has time to pump 1-2 times during her work day. Another has a SIX month old 
and has been pumping 3x per day with a hand pump since 1 month but is giving 
lots of formula, too. Wants to know how to get baby back to the breast. ( Baby 
"won't latch") Another one is only pumping 3 times a day for a 32 week premie 
who is now 35 weeks and going to go home soon.She was instructed to establish a 
milk supply and keep up regular pumping sessions, was provided a Lactina 
through insurance with double kit. And there are pumps in the NICU to use in plain 
sight.  Everyone wants "the magic pill" and doesn't understand that the 
breast makes as much milk as you tell it to. In all cases, I recommend an electric 
hospital grade pump, "super pumping" for 48 hours or more, will suggest 
fenugreek, reglan or domperidone, depending on her resources and acceptibility of 
the idea. But when I tell them it works best to pump more while taking "meds" 
they still don't get it. Looking for some tactful and productive ways to pull 
these situations out of the dumper.
Feeling less than productive today,
Mary Kay Smith, RN, IBCLC, LLL Leader
Canton MI USA a suburb of Detroit

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