>Hi All,
>
>      I have a client who has a tremendously fluctuating milk supply.  I told
>her I would post here today for possble insights.  This is one of those
>whose supply is "all over the place".  You'll understand that by the end of
>this posting. 
>
>G1 P1, vag delivery, uncomlicated, 6#15oz.
>sleepy baby, not gaining well.
>mom starts fenugreek/blessed thistle and rents scale to do pre and post
>feedings. (advice from someone else)


I'm coming at this from the viewpoint of someone who deals with 
mainly non-clinical situations, and I am assuming this baby is 
basically healthy and well. But my eyebrows shoot up at this very 
first intervention.

A baby who is sleepy and not gaining well? The mother does not need 
to be messing about with two different herbs and an in-home scale and 
weighing. First thing to do with a sleepy slow gainer is to get 
mother and baby together, feeding, with someone observing at least 
one feed all the way through. The usual cause of slow gaining is not 
enough milk getting into the baby - that's usually easily fixed with 
more feeding, day and night, using both breasts at least. Maybe 
breast compression if the baby is too sleepy.

>Mom calls me when baby is 5 wks old and very fussy.  Gaining well.  But
>eating 5-6 oz every 3-4 hours!  (now 9#) Mom pumps off 15 oz(!) after am
>feeding.


!!!! That's crazy, sorry - what is the mother thinking??....pumping 
this amount is going to send her supply sky rocketing. And why is she 
feeding with a bottle (am assuming she is doing this, otherwise she 
would not know how much the baby is taking. So that's more 
expressing, more over-stimulation, more fuss, more messing about.....)

>* obviously oversupply!  AND reflux, as baby refluxed several times in my
>clinic whenever placed semi reclining. Note to doctor, baby started on
>zantac.


So this baby is now *medicated* because of the mother's super-stim of 
her supply :(

Sounds as if you have worked hard to try and get some normalising 
behaviour in here, Linda!

Ther rest of your post describes a complicated, changing and 
disorganised regime of pumping, herbs, more meds for the baby (!), 
feeding and scalding ebm....yikes!

How about just going back to basics and feeding the baby direct from 
the breast, responsively and unlimitedly, for about two weeks 
consistently, and see if things calm down a bit?

Mother thinks the baby is ill - I see the baby is thought to have 
diarrhoea and is going to be investigated by a GI specialist. More 
intervention. More head scratching.  More tests. :( :(

Heather Welford Neil
NCT bfc, tutor, UK

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