Dear Esther:

The mother you are working with has much in her context of breastfeeding
that could contribute to a dwindling supply. I think many good suggestions
have been given already: the possibility of Sheehan's syndrome from blood
loss, the negative effects of inadequate closeness with her baby, lack of
stimulation, stress... Importantly, Kate Sharp posted about a mother with
milk who also had a hysterectomy, is grieving, and does not have a
depressed milk supply.

There are many things that can be tried to see if they make a difference. A
plan of action might include greater access to her baby--as much skin to
skin as possible prior to pumping (Kangaroo care in the NICU), pumping in
the NICU near her baby, checking the quality and function of the pump (is
it working as it should?), the fit of the flanges, whether anything is
getting in the way of her pumping regularly and comfortably, what kind of
emotional support she is getting for having a baby in the NICU, for having
 had emergency surgery, for just having lost her uterus (what services
might the hospital be able to provide, what is available in her community
[see "Helping Breastfeeding Mothers Grieve" on the publications page of my
website], whether anyone is pressuring her to stop pumping--giving her
messages that "pumping is just too much stress for her and she should just
let it go," etc.

Best wishes to all involved,

Cynthia

Cynthia Good Mojab, MS, IBCLC
Ammawell
Email: [log in to unmask]
Web site: http://home.attbi.com/~ammawell

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