A mom in my practice is pregnant for the second time with EDC in early
December.
Mom is a 40 y/o G2 P1001 whose first breastfeeding experience did not go
very well.
Her first baby was term and uncomplicated. The baby breastfed well in the
nursery but when seen in the office on day 5 and 6 was losing weight without
good signs of increasing milk supply. On day 5 the baby was started on
supplemental formula by finger or syringe feed.
Mom used two 3 day courses of fenugreek without significant improvement. At
6 weeks mom returned to work as a high school teacher. Her husband was a
college student at this time. Mom had little to no time to pump while
teaching during the day. The baby was breastfed and formula bottle fed until
9 weeks when all breast feeding was discontinued. Mom did notice or perceive
a difference in milk supply on less stressful days, when her day was easier
and husband didn't have papers or other excessive college work. Mom at no
time felt any significant fullness in her breasts.
No history of breast trauma or surgery.

I've discussed some ideas for this coming baby with mom. I think the most
important will be the fact there is now an on site day care at the school
and mom can go there and breastfeed the baby between classes twice a day.
Other ideas we've discussed are labor and delivery with little to no pain
meds. Mom is looking into non med pain relief. (I agree with Kathy D. about
Americans and pain, with rare exceptions, just don't tax our tea or bomb or
Navy bases)
Breastfeed ASAP after birth and room in.
Consider pumping on day 2 to increase supply. Thoughts on this? I figured
day 1 can be just for the baby. Use of fenugreek and blessed thistle or
Reglan if needed.
TIA for your collective ideas.
-Rob



Rob Cordes, DO, FAAP, FACOP
Wilkes Barre, PA
mailto:[log in to unmask]

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