Ann Marie writes:

Birth:
Vaginal, home waterbirth
Labor start/stop, lasting 6 hours
Nuchal cord X2
Military/brow presentation
Precipitous delivery
Birth weight 9 pounds 2 ounces

Postpartum:
Significant events:
1. blood clot left calf developed at 2 days pp, treated w/ daily aspirin
2. IM progesterone given on day 4 for PPD symptoms, 200 mg IM loading dose, 
followed by 100 mg IM every other day X 8 doses (was supposed to have a 
total of ten doses, but I was concerned that it was responsible for low milk 
supply, so stopped it)
3. Baby to chiropractor twice for adjustment of atlas due to 
presentation/birth trauma

Meconium passed within two days.
First week: milk in at 36 hours; tight jaw excursion, suboptimal/shallow 
latch. No audible swallowing. Infrequent/light urinations and stools. Very 
frequent feeding.

Baby weights: 8 pounds 7.5 ounces, to 8 pounds 11 ounces, to 9 pounds 1/2 
ounce, where it stayed for four days.  Started using SNS, pumping after some 
feeds; weight to 9 pounds 5.5 ounces, and two days later to 9 pounds 2 
ounces.

Suck eval shows inability to maintain seal, smallish buccal pads, not a 
strong suck.  Swallowing ONLY with breast compression.  Stopped SNS, now 
pumping 8-10 times/day, bottle feed (2+/- ounces) after BF attempts. Minute 
transfer of milk via pre-/post-weights.  Supply diminished - started pumping 
and got 4-8 ounces/day...now getting 20 ounces/day.
Baby to craniosacral therapist - much improved temperament and jaw 
excursion, still unable to transfer milk.
Will latch and "hang out" at breast when not frantically hungry, and also 
after bottle feeds as a way to get sucking needs met.
Weight now, 11 pounds, 2 weeks after start of weight issues.
Domperidone en route.
Using donor milk, my milk, occasional AIM."

Ann Marie,
This may be obvious, but did you consider a tongue-tie? Inability to feed effectively, to maintain seal and structural 
problems are all consistent.  Also, I use more herbs than just blessed thistle and fenugreek--have you at least included 
goat's rue? Did you have an adjustment (CST or chiropractic)?---can definitely affect milk supply. Any sense that 
you may be having an issue with MER? Try rescue remedy before pumping/feeding.

Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC


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