Hi all,
Just an update on my dear daughter and darling grandbaby and the
breastfeeding situation. I'm completely at a loss, and will value any input from any of
you. I'm pretty conversant with low milk supply issues, having been
practicing as a lactation consultant for nearly 20 years, but perhaps I'm
overlooking something. Also we are working with a physician that Jill (my daughter)
loves, but who doesn't seem to be quite with it as far as doing any of the
things (lab work, and so on) that we have suggested. her idea for increasing
milk supply was to not drink any caffeine. For those of you that missed the
birth story, Nathaniel was born with a tongue tie that is so thick that they
could do a minor clipping, but not far enough that he is able to really latch
on, even w/ a nipple shield. Anyway:
Jill began pumping within 3 hours after delivery. Unable to hand express
any colostrum. Pumping, using a Classic, and then a Symphony, and then a
Classic (after she came home) continued on a regular basis. No drops of colostrum
seen until after she got home on day 3. By day four, she could get about 4
cc after pumping 4 times. By day 5, it had increased to 10 cc in 4 pumpings,
and by day 6, it was about 10 cc/pumping. By day 7, the colostrum had
turned to milk -- could see the color change. By day 12 (yesterday), she is
getting a smidge over 1 ounce (total) per pumping.
Significant history: Nothing. Good breast changes (B cup to D), good
veining, minimal spacing between breasts, no thyroid history, no infertility, age
30, no surgeries, no PCOS, no history of any illnesses that would impact
breastfeeding.
Physician won't do a uterine ultrasound to rule out retained placenta
because she has no symptoms (except low milk supply). Doc did start her on Reglan
two days ago. Jill is pumping at least 8 times a day, and has done some
"power pumping" (every hour for 4 hours in a row) occasionally. She hasn't felt
any breast changes in the last 12 days, no fullness, no increase in size, no
milk "surge" of any sort. I can palpate some breast tissue, but I too have
not really felt any changes.
I wanted her to get prolactin levels, but the physician declined along w/
getting an HCG level. (Physician said the HCG would be positive for up to 6
weeks).
Any ideas or suggestions? This has really gotten all of us bamboozled (from
an LC point of view) and completely frustrated and miserable (from a new
mother and new Grammie point of view).
Talk about the penultimate lactation consultant nightmare!
Jan Barger, RN, MA, IBCLC and very sad and frustrated Grammie.
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