Hello all,
I have a question related to case #1 of Dr. Denhez where the lady has
none or  very little milk:
I had a mom who needed a much better position and latch of the baby
during 1st 24 hrs after c-section birth, which we accomplished. Baby
stayed at breast, nursed long, and relaxed during and was content after
feeds. However, I did not hear swallowing. (BTW how and when do you use a
stethoscope to evaluate swallows, if you would do it?). Before the feed,
mom could express no milk at all and neither could I. She wanted a pump
and she got nothing from right breast and about 3 little glistening drops
on left  breast with double medela classic electric setup. At this point
she wanted to supplement and wait a few days for her milk to come in. Of
course we discussed why this was not recommended. I encouraged her to
continue with the good positioning and deep latch for now.  Anyway, my
questions are:
Would you worry if no swallowing, milk expression, pumped milk at this
early date? Which one of these? I always feel the pump does not get much
out at this time. Would you do any other interventions at this time? Test
weighing? Blood sugars? Could this be MER problem, which would not be
well established at this time anyway, right? When would you start to
worry? This mom had no risk factors in history (e.g. breast surgery,
injury, infertility, she did have breast growth, and nipples appear
normal and erect.). Please share your collective wisdom.
Laurie Wheeler, RNC, MN, IBCLC
Violet LA USA