hi Katherine,
Where to begin? The baby, it seems, is now 3 months old and Mom was
hospitalized for 1 mth- is that right ?-poor thing!!!
 First of all , I'd have some questions regarding the first LC's seeming
assumption that the baby wasn't getting enough hindmilk, you didn't say -was
that based on a consult and assessment of the breasts or via the phone? The
baby's weight gain was ok (a little over 1/2oz /day for this time period), at
least according to blanket expectations but certainly doesn't suggest an
oversupply -(and thus would not support the "not enough hind milk"
suggestion) AND who knows, this weight gain could actually be low for this
baby.
I'm also confused about why this Mom would go so far as to try Reglan but not
breastfeeding during the day!? It is obvious to me that if this baby will
nurse at night,he will nurse during the day as well if hungry enough- has she
tried compression and the football hold. I personally have found that for a
lot of women, the fball hold allows for faster milk tx and have used it
(alone) many times as a successful technique to improve weight gain. The SNS
would really improve his "interest" at the breast, if used correctly.
 My advice would be to go with what , i think, you are already thinking; no
bottles, some spoon or dropper supps-i think a 3 month old might really balk
at a cup but its worth a try and most importantly, a consult-you can help
with latch, positioning changes to facilitate improved milk tx, compression,
supply assessment(!) and proper use of the SNS! I don't know if this is the
case with you but I think with myself, far too often I'm trying to help over
the phone when I shouldn't be!
Lynn Shea Rn, Bsn,Ibclc
Franklin, Massachusetts

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