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From:
vgthorley <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 27 Feb 2006 15:15:06 +1000
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Renee posted about a breastfeeding mother of a 9-month-old, who is pregnant
again.  This is is one of the most common situations I am asked about by
Mums -  breastfeeding during pregnancy and tandem breastfeeding.
I am delighted to read, Renee, that you have referred the mother to the LLL
book, Adventures in Tandem Nursing, which is an excellent resource and will
answer her questions (and other questions she didn't know she had).  You
have given her the understanding and support she needs. While there is
individual variation in the experience of breastfeeding during pregnancy, as
in most situations involving the human body, here are my 2 cents' worth.

- It's common to have a decline in milk supply a few weeks into the
pregnancy - sometimes it's the first sign of a pregnancy.
- I'd recommend *avoiding* fenugreek, since some sources say to avoid it in
pregnancy, since the effects are unknown.  It also lowers blood sugar.  In
fact, I'd be wary of galactogogues by mouth just now, any of them.  Best
that she *feeds-feeds-feeds*, the best milk-making mechanism of all.
- Supply *can* be increased.  I suspect this is an individual thing, as
regards how soon and how much.  As you have told the mother, the baby is
probably going to need some other fluids and some nourishment from other
sources, for the time being, but to feed-feed-feed at the breast should have
an effect.
- I'd also suggest *rest* as the mother is at a stage in pregnancy when
women tend to feel weary, and if she gets a rest she'll feel all the better
for it - and that will be good for the supply too.
- A "holiday in baby with the baby", even for a day, often works nicely, as
long was a mother feeds-feeds-feeds.  This can be repeated a few days later
or the next weekend, if necessary.  Rest for Mum and lots of skin-to-skin
for mother and baby.
- If the mother needs to top up her baby, for now, she will probably be
happier using an ordinary cup.
- In my personal experience, breastfeeding during three pregnancies, I found
each time that my supply seemed to increase with contined breastfeeding.  On
the first occasion, I increased my milk supply exponentially in an emergency
situation (marooned overnight on an isolated road in the Australian bush, in
very hot weather).  My first baby was at that stage receiving about
one-third of her milk needs from me.  It was on dusk when her father bogged
the car, and I lay on back seat of the car and fed her at roughly hourly
intervals overnight.  (No, I didn't keep track of time, but that was a close
estimate.)  At no time was her hydration compromised.  It never even
occurred to me that I wouldn't be able to increase my supply, even though
pregnant.  When we were able to get a lift into the town and other food was
available, about 16 hours later, my daughter was bright and chirpy.  I might
add, had we not been marooned, during that 16 hours she would have had small
amounts of solid foods, too.  A more detailed version of this has been
published, in the NALC Newsletter.  See:
Thorley, V. Increasing the breastmilk supply during a pregnancy: an
emergency situation. Network of Aust Lactation Colleges Newsletter 1997
July; 1(4):12-13. [Personal account]
- Best to steer clear of "drying" herbs, such as sage (as in poultry
stuffing) and peppermint, as I'm sure you will be aware.

'Bye for now.  I've been "nomail" for ages and have just come back on
lactnet for 24 hours.
Cheers
Virginia

Virginia Thorley, OAM, ThA, BA, DipEd, GC TESOL, MA, IBCLC
Lactation Consultant.
Cultural Historian working in the History of Medicine.
Brisbane, Queensland, Australia




I have permission to post.  Mom is breastfeeding a 9 mos old  baby girl.
She
has recently found out she is pregnant.  Never had a  menses and is guessing
to be 8-12 weeks pg.  Her daughter eats a small  amount of solids, but still
prefers the breast.  She refuses outright any  bottles.  Mom states milk
supply
has significantly dropped.  She  started pumping again and was only able to
get "1/4 tsp after pumping for ten  minutes, if that".  Baby is frustrated
at
the breast, but is still nursing  and finds much comfort there.  Mom is
EXTREMELY dedicated to breastfeeding  and is devastated at the thought of
giving
formula.  Mom wants to try  Fenugreek, but has gotten conflicting
information on
safety during pg as she has  heard that it causes miscarriage.  She has seen
a
product that contains  raspberry leaf, nettle leaf, and alfalfa leaf that is
supposed to increase milk  supply while being safe during pg.  Was wanting
to
know if that would be  worthwhile.  I personally have never heard of
fenugreek
causing  miscarriage, however since I am unsure wanted to check with you all
first.   While I have heard of Raspberry Leaf for healthy pregnancy, had
never
heard it  used for breast milk supply, as well as the other herbals.  (Guess
I
need  to bone up on my herbal galactologues).

I have told her about the book, "Adventures in Tandem Nursing" and  she is
running to the bookstore after her daughter wakes up to get a copy.   I know
she
will get great information in there.  She is already active in  LLL however
is having some issues with her group leader and doesn't feel able to  get
assistance there.  I have given her tons of "atta girls".  I  have talked to
her
about using a sippy cup instead of a bottle.  She tried  that and baby took
it
well.  She had some EBM in the freezer and said baby  sucked down the 7 oz
like
there was no tomorrow.  She says she only has a  bottle or two left in the
freezer and is worried what will happen past that  point.  She honestly does
NOT
want to use formula.  I explained to her  that her baby had to be fed, and
to
watch her baby.  She is going to watch  and see if baby seems to be
transferring much milk, or getting a let down of any  significance.  She
will be trying
to increase solid foods.  IF the  baby doesn't seem to be transferring milk
well and refuses the solids, I told  her some formula may be needed.  Also
told
her she should not feel "guilty"  as she is doing everything right.  She is
willing to try anything and  everything to ensure a longer breastfeeding
relationship.  I also explained  to her that breastfeeding was more than
food, and
that she should continue to  offer the breast for comfort and love.

Did I handle this well?  Tandem nursing is something I  personally have no
experience with and don't want to do or say anything that is  going to hurt
her
situation.  Anything you might suggest?  What about  those galactologues?

TIA for your assistance.

Renee Drake RN CLC
Nursing Cate for 23 months (and NO illnesses or ear infections this  winter
at ALL!!!)

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