Hi!  First off I want to say how much I have enjoyed this list and learned
from everyone's experiences!  This is my first time posting to the list so
please excuse me is I do something wrong ( I think I sent my question to
some individuals accidentally)

Mow for my concerns-- I'm a nurse in a small rural hospital where we do all
the breastfeeding assessment and counseling as there is no lactation
consultant.  My pt delivered 5 weeks ago and boy 7-9 (one shot of demerol in
labour).  Babe latche dwell in the hospital.  Mum left @ 48hrs.  Christmas
came and went and the mum was nursing Q2 hrs and a 2 weeks the babe was 7-1.
At that time her Dr. recommended supp with ABM by cup of syringe as the babe
was dry at that time with no wet or dirty diapers.  At 3 weeks the babe was
7-2 and at 4weeks the babe was 7-12.  The babe was very hungry and the supps
got larger even though breastfeeding was offered and done first or well over
an hour for each feed.  Mum was pumping post feed and taking domperidone
(max dose)  Mum is now exhausted and totally discouraged and getting alot of
feedback that she is starving her baby and so has decided to bottle feed and
breastfeed together. q2-3 hrs. at 4 weeks5days test weighed for 50 gm
following 20 min each side, appears to have an good latch and suck.  The
only problem that I can figure is poor supply and my knowledge base  is
exhausted as to how to increase it any more.
Is there any suggestions to help improve the supply and how to support the
mum in her efforts and obvious desire and commitment to breastfeeding but
not having exclusive success.  I also should tell you that my pt was an
infertility pat and conceived with much hormonal intervention with estrogen
and IVF.  Mum states the she does not have afeeling of letdown and during
her pregnancy did not have and breast changes.  I look forward to hearing
your ideas   Heather