Hi All, I just feel the need to vent a little. Yesterday I had parents come for a visit with me who have a 5 month old who weighs 11#1oz. BW was 8#6oz. She just changed pediatricians because her previous one was telling her she needed to supplement. The pedi here in our office that saw her asked me to do a pre and post wt check with them so that we could have a more objective view of what is going on. (she told me how they were new pts to us and why they had left their previous doc) While asking my questions, I asked if she had seen another lactation consultant ever, and they stated that they had when their baby was 3 days old, but it was a "bad" visit and so never saw one again. I asked what had happened and they told me that the baby hadnt gained any weight yet and the LC had the mom pump and they didnt get anything out, and so mom was told to supplement, rent a pump .... WELL...obviously at 3 days it is normal to not see weight gain, and not all breasts respond to pumps ... but the info provided by the LC wasnt bad or incorrect, just not what the mom wanted to hear. (just as a FYI for all my Austin buds, they were from another town at that time) :-) SO... I do a pre and post in my office and after 20 minutes on one breast with no audible swallows, baby took in 2cc! Put to opposite breast for 5 minutes of nothing audible, mom switches back to first "more productive breast" , gets a let down, 1:1 swallows x 30 seconds, and baby pops off done. Took in 18cc! (total 20cc) YIPES! And now its all on me to present to this mom in the most delicate manner that she is not producing enough - and in such a way that we don't also lose her as a patient! The baby seems to be meeting all her milestones. She certainly "acts" like a 5 month old, but she looks like a 2 month old. Dad is small statured (5'5"), mom is (5'9"), and others in family hx are 4'11 etc... Mom breastfeeds 24/7, almost literally! So, of course, I praised mom for being so available to the baby. That she is absolutely beautiful and appears perfectly normal mentally and emotionally. Of concern is how her growth curve is now going down. Explained how it is alright to have a baby in the 5th percentile as long as they continue on curve, or go up on curve. They said how they kept watching her head circumference as they know that famished kids have larger heads because all the nutrition goes to the head to protect the brain. Mom absolutely hasnt wanted to use any formula. She did agree to trying some in office...which of course the baby didnt want to have anything to do with. We discussed trying the SNS as the baby loves to breastfeed, but mom not happy about that and doesnt want to try it. We discuss the formula that they can get at health food store, we discuss trying to get some donor milk, we discuss galactagogues.... Of course, mom only has manual pump. We do some manual expression and get NOTHING ! Poor mom is trying hard not to cry. I touch her leg in empathy and she starts crying. I re-emphasize what a terrific job she has done up to this point; how well attached they are; how great it is that they co-sleep and use the sling ... Mom leaves office with samples of formula and some fenugreek seed capsules. (I work in a pediatric office that has samples of formula) I suggest to them that they mull over all their options through the weekend, and we will talk on Monday and come up with a plan. They are OK with that plan and sadly leave my office. ECK. I hate it when moms dont produce enough milk! I hate having to be the bearer of bad news. And I also hate how the doctor put it all on me! Tho I guess I could look at the positive - that the doctor thought I would be able to present it in such a way that the parents would not feel threatened. The only "red" flag she had in possibly not being able to produce a sufficient supply, was that she experienced very little breast growth during her pregnancy. So its possible that she doesnt have enough mammary structure within the breast to produce enough. I made sure they understood that I was in no way stating that they were going to have to stop breastfeeding, and that the baby was way too attached to mom and to breastfeeding for that to be an option, but they are probably going to have to consider some form of supplementation to the breastfeeding, unless the fenugreek suddenly increases her supply. I gave her a handout that discussed all the ways to increase your supply. (from pumping to all the various herbs to reglan to SNS to breast and bottles...) Oh well, I've rambled on enough. Linda *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html