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Subject:
From:
"Catherine Watson Genna, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 10 Jul 2010 17:13:28 -0400
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If she's pumping out all the milk the baby would otherwise get, no 
wonder the baby is fussier than ever at breast. How about using a 
supplementer at breast, with  the pumped milk, and then shortening 
pumpings to about 5-10 mins immediately after breastfeeding? Removing 
the 'spare' milk after the baby detaches seems to help increase milk 
production over time.

Often when mothers report milk production that seems to crash and a 
negative pregnancy test, I plot a growth chart for their baby from 
birth. Often you can see that the baby's growth started to slow 
significantly earlier than mom thought there was a problem. In other 
words, the problem onset was gradual. Sometimes mom can identify what 
happened when baby's growth dropped - one mom went back to work, another 
mom's baby got a respiratory infection and didn't feed as well for 
awhile. Sometimes it was very gradual and they can't point to a 
precipitating factor, but you might find a suboptimal latch or a 
tongue-tie, and a growth chart that shows the baby has been steadily 
slowing in growth velocity. Particularly if the growth has been 
declining steadily, domperidone might really help. Don't neglect to 
optimize management too.

The WHO growth charts are available online.

Catherine Watson Genna, BS, IBCLC  NYC

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