>5-6 times a day is not enough to pump!  Have her try 8-10 or more
>pumpings, and make sure she is using a hospital grade electric pump.

I can picture this harried mom thinking, "8-10 times a day??  On top of all
the nursing and the SNS??"  But here's what I suggest to moms:

If there isn't a fundamental supply problem (thyroid, whatever) - if supply
is low because baby isn't driving the system - then nursing the baby a lot
isn't increasing supply *or* feeding the baby.  For now, think of nursing as
recreational only.  Nurse as much as you like, but don't think of it as
food.  Rely on the pump.  It's fast, it's effective, and *that's* what's
going to bring your supply back.  Feed the baby in whatever way is efficient
and pleasurable for both of you - probably bottles.  Once we get the puzzle
sorted out and the baby begins to drive the system, we'll transition from
pump to baby.  But for starters, don't exhaust yourself nursing
continuously.  If that worked, you wouldn't be in this pickle.  Let the pump
do its job.  For now.

I know in theory a feeding tube should cause baby to draw effectively and
consistently. In practice, my impression is a good double pump (which
doesn't pause, complain that there's nothing there, chew, lose the tube, or
go to sleep when the flow slows, and which does both sides in 15 minutes or
less) pulls a really low supply up faster than fiddling with a feeding tube.

What do others think?
--
Diane Wiessinger, MS, IBCLC, LLLL  Ithaca, NY
www.wiessinger.baka.com

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