Barbara,
Sorry I'm a day or so late with reading. Re your client who had a
lumpectomy, radiation, and chemo: I would do the usual increase supply type
interventions. 1. Make sure the baby is getting full adequate amts as you
are doing, and f/u for wt gains 2. Nursing supplementer at breast, I would
use both breasts. If one side supply is very low, the baby will just take
more off the supplementer. 3. Galactagogues - herbal and prescription; make
sure there is no contraindication w/ the cancer history. 4. Post-feed double
pumping if she can handle that to further increase supply and provide ebm
for the supplementer. Even if the treasted breast does not bring in much of
a supply , why neglect it, you might get 15cc, every bit counts and it is
really just as easy and quick to pump double. Might boost prolactin levels
which may help in early days. Hope this helps some.
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA




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