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Tue, 11 Aug 2009 12:28:36 -0400 |
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Hello,
I have had a number of moms I've seen lately with difficulty sustaining an
adequate milk supply. A couple of these cases have been moms with twins.
The usual scenario: mom has her babies, is supplementing (with SNS or bottle)
in the hospital due to prematurity and/or weak suck, and goes home pumping
after each feeding attempt to faciliate emptying of breasts.
The moms I have worked with are motivated, and I have no reason to believe
they are not pumping as frequently as instructed. I have had really difficult
problems with these moms becoming frustrated at lack of milk production and
becoming sick and tired of pumping for days and weeks on end. A common
question is "when can I stop doing all of this pumping"? It also doesn't help
that baby slurps the bottle down, and will not nurse for more than 3 minutes
before falling asleep, even at 3 or 4 weeks of age.
Moms who use the SNS find that baby begins to nurse less effectively over
time, slurping on the tube or flat out refusing to nurse without the device in
place.
I am wondering what other LCs do in situations such as this? We try herbs,
tinctures, domperidone, reglan. Nothing seems to help. It seems that once a
mom goes home with a non-nursing baby, the hormonal response to the pump
is just not the same.
I would really like feedback on how to more effectively counsel the mom in this
situation - do I tell her to pump less frequently, and possibly risk her supply
from decreasing even more?
Thank you!
Brenda Phipps, BS, IBCLC (for 13 years, and still learning!)
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