I've been working with a mom who delivered at 35+ weeks 11 days ago. She had minimal breast changes with pregnancy and her supply has been low, around 20-30 ml. every 2-3 hours. They went home 2 days ago and she called this morning in a panic because the last 3 times she pumped she got virtually nothing. She states her breasts feel very tender, but not hard and no lumps. She has not been taking any galactagogues because she got a shot of Betamethasone before the birth and I know some feel this is associated with delayed lactogenesis and I like to give them 2 weeks before they start taking galactagogues in that situation.

I recommended she try some hand expression and just keep pumping, but I am stumped about why her volumes would go to nothing all of a sudden. She is diligent about pumping and does lots of skin to skin. The baby even breastfed 10"/side this morning.

Any ideas would be greatly appreciated.

Andrea Tran RN, IBCLC
Erie/Boulder, Colorado

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