No pumping for 5 days will certainly decrease milk supply.  This mom
will need to pump much more to overcome the initial message to her
breasts that milk is not going to be needed.  Usually it helps to use a
factory analogy to explain the supply and demand principle to mom, and
tell her that she has to make sure the marketing research is successful
(shows a large demand for the product, milk).

I suspect (there is NO research on this, but I have seen quite a few
cases) that pregnancy bed rest can increase the risk of sensory
integrative dysfunction in the baby.  They are probably screaming
because they have no idea what to do, and the milk supply is too poor to
give them much motivation to try.

Edema during pregnancy can be related to poor protein intake.  With
twins, protein demands are increased.  Muscle atrophy due to bedrest
will make mom feel even weaker.  Do you have physical therapists who
make home visits in your city?  Perhaps mom's doc could order one for
her to help her get her strength back.

This poor mom has a multifactorial problem.  If she can be persuaded to
increase and protect her milk supply, everything else can be worked on
later, when the unsupportive carer is gone.

--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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