>Today I saw a pt in our clinic.  Little milk with first baby who was 
>admitted for dehydration, LC had told her not to supplement.  He is 
>3 now.
>With this baby she has new hopes to breastfeed.  I did inpt. rounds 
>with her on Saturday.  Baby  was latching like a champ.  She started 
>pumping 6x a day.  I told her to supplement baby 1/2 oz here and 
>there as needed.  And we would see what her body would do with her 
>milk supply.
>Today baby is one week old.  She has pumped only drops.  Baby was 
>mildly jaundiced.  Peds doc told her to feed him more.  She is 
>feeding him formula.  Crying a lot during the visit.  Mentioned the 
>'ghastly' sns she heard about from a friend.  I told her I would 
>support her whatever she decided.  She was ready to stop 
>working/hoping for a milk supply.  Not interested in reglan or sns. 
>We talked about the parenting umbrella being bigger than the feeding 
>method, how she can still hold baby skin to skin as much as she 
>wants, let him nurse for comfort.   She hugged me when she left. 
>I know I was in the right place at the right time today.
>Susan in Minnesota
>rn ibclc


Susan, I hope this mum achieves her goal :)  I so agree that when bf 
is not going well, mothers sometimes need to be reminded that the 
closeness of bf can remain.

I need to ask respectfully why this mother would be advised to pump 
(assuming the supplements you were suggesting were ebm, yes, and not 
formula?) so many times a day....if the baby was feeding well and 
latching well, why would she have to pump from day 2? Was there some 
other reason to pump? I ask this, because it is hard work to express 
milk at all, and especially this many times a day, and there is a 
risk that mothers start to judge their milk supply *not* from the 
behaviour, responses and bodily functions of the baby, but from what 
they can produce for the pump.

Is this perhaps something the mother wanted to do, to ensure she had 
more milk than last time?

The vast majority of mothers, as we know, can make plenty of milk for 
their babies as long as they keep the baby close to their body, feed 
responsively as and when the baby, or they, want to, and there's 
normally no need to supplement with ebm or formula.

Please don't assume I am being critical - I am genuinely puzzled as 
to why this mother needed interventions and it may be the whole story 
is not in your post.

Heather Welford Neil
NCT bfc, tutor, UK

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