In a message dated 10/24/00 9:38:40 PM, Sue writes:
<< Mom is very motivated to nurse and has been supplementing with (until last
weekend) one bottle of ABM in the evening.
 Last weekend baby was very fussy
after feeds and mom resorted to a bottle ABM after a couple of feeds.<<

I'm unclear about why she is giving increased bottles of ABM........ because
the baby is fussy?
I wouldn't reccommend that as a workable choice with a baby who is almost
exclusively br fed. I assume that she is guessing the baby is still hungry at
these times and of course the fact that the baby undoubtedly takes the extra
ABM reinforces that assumption, and that is now a part of the problem. The
other potential root of this problem may lie in the fact that this baby is
receiving ABM in the first place. Some babies may be able to switch to a
bottle of ABM once/day w/o issue but this baby may not and may be developing
a preference for the bottle or ABM (yuk!) or both, which is now being
reinforced.

>>Would you try galactogogues,<<   Why?
There is no clear supply issue here and this could feed into Mom's focus on
it. You seem to have ruled out a breastmilk or technique related issue which
would be unlikely with a 31/2 mth old anyway. I would reinforce to the Mom
that she probably  "took away" from your consult a few workable little tweaks
in her aproach to the fd which may go a long way in woooing the baby "back"
or "to " the breast, to focus on the breast only for a little while until
there seems to be investment, on both sides.
Good Luck!
Lynn Shea Rn,Bsn,Ibclc
Franklin, Massachusetts-we too are enjoying a beautiful autumn, lots of sun,
70degree days and foliage!

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