Dear Lactnetters,
I'm working with a mother of a 9 mo little girl.  She is about 2 months
pregnant now and her baby hasn't gained any weight since her 6 month check
up.  From 8.9 kg to 9.0 kg.  The baby breastfeeds approx 8-9 x/24h and has
rice cereal in the morning and baby food at other times of the day.  Her
mother states she was eating well until she started "forcing" formula on her
as she was ordered to by her pediatrician's nurse.  The mother states that
she is okay with weaning but she is not okay with forced traumatic weaning
which is what she was told to do.  She was told to leave for a few days and
her baby would be forced to drink formula.  If she gave in and breastfed
her, her baby wouldn't take formula and therefor wouldn't gain weight.
Mother states baby is allergic to dairy but not soy and she has been trying
to give her soy based formula in a cup with little to no success.

Not sure what bearing the hx has but here it is:

25yo g2,p1 (pregnant now)
Baby's birthweight:  6lbs 8 oz
Born on due date (induced) but she states she was told that her dates were
off by ultrasound and that baby was really only 38 weeks at delivery.
Baby was in SCN x 10 days and mother pumped.
Mother has no hx of diabetes or thyroid problems or infertility treatments
or issues
Mother has not had breast surgury.
Mother states she doesn't remember breast changes in size with 1st pregnancy
and nothing so far with this pregnancy.
Mother states that baby gained weight well until the period of time from
6mo - 8 1/2mo.
Mother states she was told that baby is in 25th percentile now after 75th
percentile at birth.

This mother said to me that if she'd known that she would be putting her
child in danger like this she would never have breastfed.  !!!!!!  She said
the nurse told her "Babies don't starve themselves, Parents starve babies".

I will be seeing this mother in my office on Tuesday to assess feeding and
milk transfer.  The mother states that she doesn't want to pump to try and
build supply if that is the problem but wants to find a way to help her
child gain weight and gently wean.

I told her to keep offering the cup every hour or so, but not to force it.
Try to give her more of the solids.  I did encourage her to pump and freeze
her breastmilk for momsicles or make formula popsicles as a snack for her
baby.  I talked to her about getting more fat in her milk, either through
her diet or lactoengineering.  She's not keen on anything that is going to
cause more pumping since she is going through the pregnancy fatigue now plus
running after a 9mo.

I am aware of the link between pregnancy and lowered milk supply but not
what to do.  I'll be looking in all my texts, etc, but if anyone has worked
with this situation before and wouldn't mind sharing their strategies, I'd
really appreciate it.  Email me privately if you'd like.

Thanks,
Cindi Swisher, RN, IBCLC
Alliance Breastfeeding Center
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