Hi all, I need some advice and have
searched archives but still unsure. I got a call from a WIC mom who was
nursing her 8 week old (Has 22 mo. old, 8 & 11 year old) This is last baby
and only one breastfed. She has hx of depression and on Zoloft, heavy
smoker and on very low calorie diet. She was feeling let-down but
just dwindled suddenly. She got depo-provera at 2 weeks pp and had flown
to VA. (with baby) to funeral the week before she called me. Husband
away for 3 weeks, baby constantly at breast, not satisfied. Stools were
green and slimey. Her OB told her to drink wine to build up milk supply
and ped. said she could give ABM and cereal. I made home visit, baby
correctly latched and happy to be at breast. I loaned her an Elite pump
and started fenugreek. Told her to take baby to bed with her and all the
other info. She said only time baby had yellow, seedy stools was when she
gave ABM. Baby is gaining slowly and is alert. Mom could only pump
1/2 - 1 oz total (double-pumping). With fenugreek increased it only by 1/2
oz. She's not real good at pumping more than bid and now thinks the baby
is spoiled (uggh) because she won't sleep in own bed. Anyway, it's now
been three weeks of pumping, fenugreek etc. only increased milk supply by 1/2
oz. (She hates the way the fenugreek makes her smell so isn't real compliant)
. She's tired of baby always at breast and insists on giving cereal at
nite (despite what I told her). She wants to give it her best shot but
wants all or none. So she wants me to talk her MD into giving her
reglan. I think the depo has had a significant decrease on her milk supply
and wonder if any of you have had any success in getting the supply back up
fully. I did encourage her to increase her calories (she was starving and
forgetting to drink fluids all day long). She says her pumped milk looks
very thin with only a tiny layer of fat on top. My question to you is
should I encourage reglan. She told me she stopped taking her Zoloft
because she thinks that's what might be causing her problem. I'm concerned
about reglan and depression. I don't know what else to do. It is
crazy in her house and she has a jealous 22 mo. old so there are MANY factors
here. How far do I go with this. I want her to be successful. Her
other kids have asthma and the house is full of smoke (I won't go there) so I
want this little girl to have the very best chance for a healthy beginning. I'd
appreciate any advice. TIA, Kym Dunton, RN, BA, IBCLC, Amelia Island,
FL.