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Subject:
From:
Mellanie Sheppard <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 16 Apr 2008 08:32:02 -0500
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Hello Ladies,

I would love to have some input on a very interesting case.  I have been
working with a mom (G3P3) who has a history of low milk supply.  She
originally contacted me when she was pregnant with her third baby.  First
baby was breastfed for 2 weeks, not back to birth weight, doctor recommended
supplements without any info on increasing milk supply.  Baby was weaned
very shortly thereafter.  Baby #2, mom began supplementing at 8 days after
visit with LC showed significant weight loss.  Mom reports that Baby #2
always had a very weak suck, so not sure if supply issues originated with
mom or if they were a result of poor milk transfer.  Mom continued to nurse
baby #2 with SNS for 8 months.  Baby #3 is now 5 weeks old.  I saw mom at
24hrs pp.  Baby latches great.  There is some anomaly with left breast -
areola and nipple are "raised" - can't think of the exact term at the
moment.  Baby transfers less milk on left than right, but mom works really
hard keeping him nursing on it, doing continual breast compressions.  We are
unsure of baby's actual birth weight.  He was born at home and weighed by
the midwife on the old-fashioned hanging scale.  Midwife weighed him at
6#13oz.  At 24hrs, I weighed him at 6#3oz on Medela Baby Checker scale.
Baby is having 6-8 good wet diapers each day - we are talking soaking wet on
most of them.  He is having 3-4 good size stools each day as well.  He is
alert, active and is doing all of the things I would expect a 5-week-old bay
to do.  Despite all of these positive signs, his weight gain has been very
slow.  His low point, according to my scale, was 5#12oz.  His current weight
is 6#8oz.  For the last two weeks, he has gained 3.5oz each week, prior to
that it was even slower.  Mom his taking More Milk Special Blend from
Motherlove, as well as a tea she is making with Blessed Thistle, Fennel and
Nettle Leaf.  Her midwife ran some blood work.  Thyroid was normal,
hematocrit was slightly low, prolactin was really high - 229.  I have never
heard of a prolactin level this high before.  Any ideas on what could be
going on with this mom.  Mom really does not want to supplement unless it is
absolutely, without a doubt necessary.  (She did supplement on day 5, when
baby had not had any wet diapers in 12 hours.)  I would appreciate any
input.

Forgot to add, mom and dad are both small stature and fairly thin.  Older
two children are small for their age and mom reports both older children
grew slowly, even on formula.

Sincerely,
Mellanie Sheppard, IBCLC
For Babies Sake
Arlington, TX

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