Hello all! I hope someone can assist me with this situation. I have a 26 yr old client who just birthed her first baby 5 1/2 days ago today. She has a nice aggressive baby and symetrical average sized breasts with NON flat nipples. She had a spontaneous labor that was sl. long in length and did include an epidural and pitocin after delivery. In the hospital she was doing great- good latch, suck, no audible swallowing but baby did maintain her wt and was stooling and voiding appropriately. She called me the day after her discharge with concerns that the baby was "starving". She was crying almost nonstop and had only had 1 void since 4am that morning (no stool since then also). Upon my assessment in her home, the baby had another void for me but was rooting like crazy. Mom's breasts did not feel full in the least (this would have been day 3 1/2 after delivery). Mom denied feeling a lot of changes with her breasts during the pregnancy. She had a NEGATIVE hx for thyroid, diabetes, surgery, PCOS, infertility or any hormonal issues. She denied any medication use. Her own mom successfully nursed 3 babies for over 6 mos and was with this client almost continuously giving her support along with her husband. The only thing that rang a bell in my head was that this poor girl was visibly shaking (from frazzled nerves she explained). She also had not slept nor ate much. I immediately turned the tv off, put on music, dimmed the lights, calmed the baby, etc.etc. and then helped her put baby to breast. I witnessed a similar sight as I had in the hospital- aggressive baby (once calmed down a bit) with a deep latch and nice suck (on a finger, pacifier or breast). Maybe 1 or 2 soft swallows within the 10 min feed. We even relatched a couple of times to double check placement. Her suck never really changed to look like a let down suck/swallow. After the feed I could get a drop or two with manual expression but that was it. (I had already had mom take a warm shower and massage before my arrival). The same scenario played out with the opposite breast except the infant got very upset only 8 minutes into the feed. Her mouth appeared somewhat dry after the feed and her cry sounded sl. hoarse. (Pumping with a double electric pump for 10 minutes only gave us a couple drops as well.) Obviously there was no change with the breasts after our attempted feed and pump. I do not like to supplement with formula but since we had no colostrum or milk... we did not have a lot of choices. We dribbled soy formula down mom's breast and the baby readily sucked it up. We followed that with a syringe feed of more formula to get something in her tummy. Baby tolerated everything well and seemed much more content. Mom agreed to cont. the freq. feeding attempts. supplementation, pumping, etc. after I left. Her mom was going to stay and she and my client's husband were going to make she that she ate and slept. I talked to her numerous times once I got home and she revealed that she was noticing a sl. increase with her production with the last pumping session. I was thinking this was good. She seemed to be more relaxed. This mom told me that she had been excited about breastfeeding since before she became pregnant. (Yea- determination!) All along she has been such a sport until tonight. After everything she has been doing she now stated that she is not sure if she can do it anymore. She was very tearful (which I am hoping is a hormonal change/milk finally coming in sign) and upset. I tried to offer her support and encouragement and come up with a plan that would most help her. I feel so bad for her and wish that I could make it better. The thing is is that I am stumped as far what is going on! I questioned her again about her hx and she suddenly revealed that she is on and has been on reglan for "stomach issues". She has been taking it throughout her third trimester and stopped after delivery. She just yesterday took it again (10 mg twice a day) for the first time since delivery. This was also the first day she saw an increase in her production (only 5cc's but better than nothing). My question to all of you knowledgable experienced lactnetters is this.... Do you think being on the reglan could be playing a role in this? Am I just reaching for straws here? I have some experience with reglan greatly increasing a woman's supply but then greatly diminishing it when stopped so I don't routinely encourage it. Should I contact her Dr and now see about increasing the dose? Have we not waited long enough? Tommorrow will be day 6 and we are still at 5cc's with pumping. (She is obviously still supplementing). What are your thoughts? Am I missing something? Have any of you experienced a client on reglan before delivery with milk issues afterwards? I considered maybe asking her Dr to do some prolactin levels too. I am also aware of the difficulty that "nervous nellies" have with nursing too. I know that adrenaline can interfere with let down but what about supply? Please tell me what you think as I don't want to be missing anything and let this girl down. She really is at the end of her rope as am I. Thanks in advance with any thoughts you may provide. Frustrated in Ohio *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]