I have a mom that's got me stumped.
Two issues are going on.  One is that her nipples are very sore, cracked and
bleeding.  Apparently the nurses had never explained the "tummy to tummy"
issue in positioning, so baby has been feeding with her head turned.
Corrected positioning and gave some ideas for alternate positions.  Mom has
large breasts and short arms.  She cup feed for a few days, but resumed bfing
now and is getting sore again.  Baby has slightly high palate, but otherwise
latches well with good tongue motion.  No problem with frenulum.  No sign of
thrush on mother's breast or in baby's mouth.  No pain between feedings.
Secondly the baby's weight.  Baby was 12 days old when I saw her.  She was
born at 8lb 14oz.  Mom had C section after a long labor.  Baby was down to
7lbs 13oz at discharge!!  Baby was cupfed and finger fed and mom is pumping
and supplementing with formula.  She has a good electric rental pump, but
only gets 2-3 oz maximum from both breasts.  Baby was weighed at 8 days old
and was 8lb 8oz, but at the two week checkup was back down to 8lb 4oz.
Mother reports no engorgement after birth and minimal breast changes during
pregnancy.  No history of breast surgery.  No excessive bleeding.  Since she
had a C section I'm assuming she does not have a retained fragment.
Breasts are large, but soft.  I was able to express milk.  Baby went eagerly
to breast and suckled well, but not much swallowing.  Only 2 or 3 dirty
diapers a day.
She does have a history of miscarriages and took progesterone during the
first trimester to retain this pregnancy.
Could progesterone in early pregnancy affect the milk production now?  I've
suggested she continue pumping, take fenugreek and have her thyroid checked.
I'm bringing her an SNS.  Any other ideas?
Cynthia D. Payne, IBCLC
In the Berkshires of western Massachusetts

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html