A 22 yo primip delivered a 1k300g boy in the 30th week 8 weeks ago.
Mom opted not to provide pumped breast milk.  If she  could not
breastfeed directly, she did not want to deal with pumping.  Actually I
don't understand how  the  docs let her get away with that because our
NICU is almost aggressive to a fault when it comes to providing
colostrum for  preemies.  It is considered a medication for the babies
and moms are almost given no choice in the matter.  She must have
delivered on a week-end and therefore sort of slipped through the
cracks.
During the first 2 months, the poor little guy had two bouts of NEC,
intestinal surgery and was still birth weight when I was called in for a
consult.
The subject was induced lactation.  He was very scrawny, greenish yellow
in  color, and almost begged me to get him some mommy's milk, as he
could not digest anything else.
The mom had used cabbage leaves and ice packs to dry up the milk and
was on birth control pills which are not lactation friendly.  (Don't
know the English name.)  While discussing her baby's condition with one
of the other NICU moms, a well-informed dad overheard the conversation
and was the first to mention the possibility of recovering the milk
supply.  If moms can breastfeed adopted babies, then why couldn't she?
She asked a nurse who said that was the most ridiculous thing she ever
heard in her life!! But one of the ped residents who had been in one of
my lectures told her to call me and ask me.  He also suggested giving
the baby donor milk for the time being  for which he nearly lost his
job.
I was ready to give it a try if she   would comply with the pumping
regimen I proscribed and understand that this would take time.  She also
had to stop the birth control pills immediately.
The head doc would not give her Domperidone without some sign that there
was milk. After about 5 minutes of massage, skin to skin  with the baby,
and pumping with a Medela Classic, we managed to produce one golden drop
which hung on for dear life on the tip of her nipple, but we all danced
with joy at the sight of this    drop.  The doc gave us a rx for
Domperidone 1x3 and we began pumping 8x/24 for at least 15 minutes.
When on day 3 I saw that we were still getting this one  golden droplet
which refused even to fall  I put her on the dosage for adoptive moms
and asked the doc to double the prescription.  By day 10 we were getting
about 10 cc and streams!!!
Now after 3 weeks, the baby weighs 2k300 ( he is also on TPN), and mom
is producing close to 400ml/24.  She started taking fenugreek to try to
further increase her production on the suggestion of someone else.  I
suggested that she try a day of marathon pumping in order to simulate a
growth spurt.
The best part was the reaction of those very skeptic staff members who
thought we were loony to even try.  There are days that I wish I had a
toy squirt gun full of breast milk for those who think that humans have
lost the ability to provide breastmilk for their babies.
It is so nice to see when these things really work!!
Sunday we will try to get this baby to breast!!  Wish me luck!!
Would love to hear about any similar situations from anyone who wants to
share.

Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
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