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From:
laurie wheeler <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 24 Jan 2010 10:03:41 -0600
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Hi Rowena,
It seems although mother had prior successful lactations relative to milk
supply, she did not have *uneventful* lactations, and in fact had latch
problems with all children. So first I would be looking at anatomical
variations in mother and/or infant that would respond to some intervention.
For example, inverted or retracted nipples, tongue tie, low tone.
Next I would consider mother's metabolic situation, for if the dr. feels she
has PCOS, but no cysts, perhaps she has high testosterone levels or other
metabolic derangements. An LC cannot assess nor treat this herself, so I
would suggest mother see an endocrinologist that is bf friendly, or better
yet,  is there a bf-medicine person in the vicinity, even for a phone
consultation? PCOS and what is now called the metabolic syndrome, appear to
have similarities, and seem fairly complicated and not entirely easy to get
under control.
I am not well-versed in all the herbs that are used to help normalize
metabolism and hormones, but perhaps a consultation with an herbalist to
help her metabolism and hormones get back in shape. She should also strive
mightily to eat a very healthful and whole foods diet.
I would suggest a lactation aid, but I see baby is not latching. I would
suggest to mother to use a hospital-grade rental pump, for approx 10 minutes
double pumping, finish with 5 min of hand expression, if she can manage 8x
per 24 hrs.
Longer than that might be too hard for mom to do. I would suggest she
continue the galactagogues, especially the domperidone, and perhaps change
the fenugreek to an herbal preparation suggested by an herbalist, as I
mentioned earlier. Some of these interventions might not able to be carried
out due to financial constraints.
In addition to this, mom can do all the skin to skin things like sling,
co-sleeping and the like, to see if baby would latch perhaps with a shield
(since baby is used to bottlefeeding) and mom can perhaps make some changes
to how she bottlefeeds (as much like bf as possible) in the meantime. If
baby latches with the shield. hopefully a lactation aid could be used at
that point.
This case appears to me to be multi-factorial, as most cases of low supply
usually are. It would be important to not overwhelm mother with all this
information, but perhaps to schedule several consultations every few days to
discover and discuss all the factors.
Hope this helps,
Laurie Wheeler RN MN IBCLC
Mississippi USA

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