At 04:25 AM 10/17/96 -0400, you wrote:
>Has anyone ever helped a mother who has suffered a stroke to continue bf.  I
>am working with a mom 25 y/o who had a stroke 1 month pp.
Jessica, I did work with a mom with a HISTORY of a stroke, but it was many
years prior to our contact.  She did have residual hemiplegia (paralysis of
her right side).  Creative positioning, a VERY supportive father and lots of
pillows worked in the hospital.

> bf was going fine
>untill the stroke.  this mom was taken off coumadin at the end of the
>pregnancy.

why was she on coumadin

>she has had a valve replacement and a pacemaker put in.

was this prior to the stroke?

> I was
>called because the dr wrote an order for a breastpump.  when I first went to
>see her she had not nursed the baby for 6 days (or pumped)  she pumped and
>only drops of milk were being produced.  1 week later still no increase in
>production.  Baby has not been put to breast since the stroke.

others have mentioned here on lactnet cases where severe engorgement would
be expected and was not seen after a traumatic event.  Sounds similar

> This mom is
>so motivated and wants to succeed . .  I am going to see her tomorrow night
>and help her put the baby to breast with aan SNS.

What are her physical handicaps?  Occupational therapy works with small
motor deficitis and activities of daily living.  A SNS may be difficult for
her to handle but perhaps a sympathetic Occupational Therapist would find it
something worth helping with/pursuing during her therapy.


last week when I initiated
>pumping I encouraged her to put the baby to breast as much as possible but
>aparently dad hasn't been bringing baby up at night due to his work schedule
>and managing the house and a 4 year old too.  I am not getting much support
>from her doctor.  kep in mind she is in a rehab hospital and they don't see
>many bf moms.  I have been asking him for a week to write an order for a
>LactationConsult so that I can legitimately see this pt in the hospital( I
>have privileges as I am not an employee) 1 week and 2 phone calls later still
>no order except the one for the pump.  tonight when I saw her I left him a
>very nice note and asked again.  I am getting tired of my services not beig
>valued!!!!!!!

Keep trying and go through other team members too.  If you can get one
person who is "IN" then maybe you will get "in" too.  Rehab hospital teams
often are very good examples of good team work so the input from others on
the team may be very valuable.

>
>I also asked him to write an order for Medelas Hands free bra and kit.  what
>a life saver this was for this mom.  And I think her insurance shoould pay
>for it.  They pay for all kinds of other equip.I am definately going to give
>it a try.  Here are my questions:

What a great idea!!!

>1.  what about reglan?  she is only able to pump 5 times/24hours due to a
>demanding therapy schedule.  anyone know about this drug in stroke pts ?

Follow the suggestion mentioned on a different topic about calling the drug
company directly.

>2.any other suggestions for building supply?

Herbal teas?  or would that effect your professional credability?  Hard to say.

>I feel like I am this patients only advocate.... there is mention in the
>notes of depression and the need to treat with antidepressants if needed.  I
>have explained to the doctor that if she could succeed with this effort I
>believe it would go a long way to help her depression, not to mention the
>natural calming effects of prolactin.

GOOD, good points, I hope they listen to you.

Keep good notes, as the big ones say, I smell an article (case study in
JHL?) here.

-- Carla (just north of Washington, DC)