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Date: | Fri, 1 Apr 2005 10:01:32 -0600 |
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I would not think this is a central problem, as one of her breasts is now
producing a "normal" amount. But prolactin levels are more helpful if drawn
immediately before and 30 minutes after a feeding, so the rise can be
demonstrated. (or lack thereof)
Have you watched her pump? Sometimes one nipple is much wider than the
other, but you cannot tell until the mom starts pumping. These nipples
often appear "flat" with a little "button" of a nipple at rest. This would
explain why baby is only making that side sore (has difficulty getting wider
nipple into mouth), and decreased supply could simply be secondary to
decreased removal by baby AND pump. Try 27 and 30mm diameter pump flanges
and see if mom reports they are lots more comfortable, and watch for nipple
elongating farther into flange when no longer "strangled".
The most extreme case of pump flange size causing low milk supply I have
seen was a G6 mom who had been pumping for her 25 week premie for 3
MONTHS...only getting drops. She persisted because she had nursed the prior
5 without difficulty. When we put large flanges on her, she had a full milk
supply in another 3 weeks.
Kathy Leeper, MD, IBCLC
Lincoln, NE
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