The question was asked, "when do you go beyond the pump when helping a
Mom who is needing to increase supply"?  When to add galactagogues?  My
plan is to always follow Mom's lead.  When does she become anxious that
pumping alone isn't cutting it?  Or is she of the personality that wants
to hit the problem with more than one thing at a time?  I like to think
that there are many "arrows" (helpful tools) in my "quiver" and I give
them out at the time when it seems they will be the most helpful.  I
follow this thinking in my prenatal classes as well as when making
postpartum rounds so that Moms will realize this is the strategy
 we will be using.  It goes something like this: "you may have heard, or
have had past experiences with barriers to perfect nursing.  I'm not
going to tell you that something won't come up as time goes by, nor
spend alot of time explaining ways to fix it that you might not ever
need to know.  But I want to assure you that together we can solve
almost every problem that may loom it's ugly head, so please don't
hesitate to contact me."  Like I said, each Mom is different and I find
interventions most effective when following her particular "bend".  It
makes the job more challanging and interesting, but I think the results
are best.  I also highly encourage at least one good nursing book for
her to reference at 2AM when things look bleak, and give out lots of
reading material, if she gives evidence that she will read it.  Becky
Garcia RNC, IBCLC

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