Hello... 

Wondering if anyone has a suggestion for boosting supply for the mother of a 
three month old. Hx includes:

1. small amount of early formula supplementation, 
2. milk came in on the later side of normal, 
3. exclusive breastfeeding after milk was in and great wt gain on baby's part
4. pumped some during this time of exclusive breastfeeding so that she could 
create a stash of milk for returning to work in 8.2008. When pumping, mom 
would obtain 4 oz in 10 minutes.
4. steady drop in supply after micronor was started at 6 weeks. Mom noticed 
this drop due to baby's behavoir at breast and due to drop in amount of milk 
pumped. 
5. came to our office 5 days ago. My partner suggested d/c Micronor, start 
Reglan,  do regular pc pumping and regular supplementing with EBM. During 
this visit baby breastfed and took a little over 2 oz. Her wt gain is being 
monitored.
6. returned to our office yesterday. Mom has been on Reglan TID x 5 days and 
off of Micornor x 5 days. She feels like the Reglan is helping a little bit as she 
is starting to feel some fullness to one side. SHe gets three ounces with first 
pc pumping in the AM and no milk with pc pumping at any other point in the 
day. SHe d/c'd the Micronor. Baby took a little over 2.5 oz at the breast 
during this consult. Mom has only 16 oz. of EBM left in the freezer and has 
been supplementing baby every other feeding. Baby is now waking up to feed 
at night 2 x. I suggested that she speak with the MD about taking Reglan QID, 
that she pc pump in AM immediately after breastfeeding and that she wait 45 
minutes or so to pc pump at other points in the day.

Has anyone had much experience with trying to boost supply after a decrease 
in supply most likely related to bc pills? Anything else I should encourage her 
to do? Once you stop the bc pills, how long does the damage from them last? 
This mom is so crushed and of course her MD reassured her that it was not 
related to the Micronor! 

Thanks. 
Liz Mills, RN, IBCLC
Asheville, NC

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