The only woman I have worked with that had gastric bypass had a very 
small baby at full term. He had lost a ton of weight by day 7, and mom's 
breasts were extremely flacid and soft. No fullness and she could pump 
only about 15 ml total. We worked and worked and got her pumping up to 
1.5 ounces. Baby was also tongue tied but mom did not get engorged. We 
worked together for about a month and she never made a full milk supply 
but after getting the frenulum clipped baby nursed a lot better. This is 
a mom who refused to use any supplements at the breast, not the SNS nor 
syringe, as they were "too hard" so she used bottles as her main choice. 
In the end, baby was getting a lot of bottles because her milk supply 
was so low but she nursed for comfort.

Kathy Eng, BSW, IBCLC

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