Hello all,

Permission to post. 
I hope to find some answers for a mom. She is 41, G7P4 delivered via cesarean due to prior vaginal delivery (in 2007) with forceps and a 4th degree and prior vacuum assisted vaginal delivery (in 2015) with low Apgars.   History of PCOS, seizures, depression, gestational diabetes and is taking glybiride 2.5mg in AM and 5mg in PM.  BMI is 37. She says her milk never came in with her other 2, but there was a time that she pumped with baby #2 and had about 2 ounces of bloody milk but no evidence of nipple trauma. She also tried Reglan with baby #2 and discontinued it as it made her and her baby angry. 

This baby is term and at this writing is 12 hours old, sleepy and hasn’t latched. She has supplemented with formula one time. I have started her pumping and will continue to work on latch hoping he becomes more wakeful. We cannot hand express any colostrum yet. She loves doing skin-to-skin with him.

She has an extensive history and would like to know her best scenario.  I want to make sure I am doing everything I can for her. 

What are your thoughts?

Thank you,
Rita Madden RN BSN IBCLC
Midwest USA
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