Theresa,
I have a couple of thoughts. Has this dyad been seen in person, or has
contact been over the phone or email? They need an in-person consult. I
would be concerned how much her milk really "came in," having seen many moms
with a very slight increase in fullness and quickly changed to a very soft
breast, and mom having no prior reference point states that her milk "came
in."
Another concern is the depo shot, of course, and how much the usual
relactation measures will work. I agree with another poster that the wt gain
is no indication of the effectiveness of the bf, becoz baby is on large amts
of supplements. They may, in fact, be needed. The plan of gradually
decreasing the supplement is a good one, however the baby needs close f/u
becoz like I said the mother's breasts may or may not be capable of picking
up the deficit. One thing that might be tried is a nursing supplementer at
breast, a homemade one can be used if you have access to a #5 French feeding
tube. The herbs and/or reglan may help, I have seen them help in many cases,
however having the baby at the breast very frequently and/or pumping (even
for 5 minutes double sessions) many times after or in between feedings, I
think would work even better than the drugs.
Laurie Wheeler RN MN IBCLC
Mississippi USA

Dear Collegues.
I have permission to post. This mom was not going to breastfeed and formu=
la=20
fed her baby the first 3 postpartum days until her milk came in. She rece=
ived a=20
depo provera shot before discharge. Her milk came in and she began to=20
breastfeed. She has had to supplement up to 3 ounces after feeding both=20=
sides. She was given a pedal pump from her peer counselor and she can pum=
p=20
1/2 ounce after feeding both sides.=20
My question to you is do you think Reglan could help her? I would let her=
 use a=20
hospital grade pump but they are all out. I only have three rentals and t=
hey=20
are out most of the time and I never collect any rent. It seems the most=20=
needy are the ones that aren't able to afford to rent.  I suggested mothe=
rs'=20
milk tea or the herbs if unable to take tea. I also suggested the Reglan =
from=20
her physician. She would not be able to afford Domperidone from a compoun=
d=20
pharmacy.=20=20
Baby is growing well and her weight is up as well.=20
My email has changed. I have tried to do it on Lactnet but am having=20
technical difficulty. I have tried to forward everything to my work addre=
ss=20
because it is so much faster. Please email me at [log in to unmask] if poss=

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