I'm Julie, an LLLL from WA state.  I've come here because I had an unusually tough call, and have not been able to find much helpful information for this mom.  She did give me permission to discuss her case here to find some help.   I was not at all sure what to tell her, but did offer support and empathy for the major frustration she's having now.  If anyone can help, please let me know what I can pass along to her as she's at the point of giving up though she doesn't want to.

Her first baby was also born early, and had trouble initially.  But she pumped and bottle fed and by 1 mo old had the baby to the breast and nursed for 2 years.  So she does have a prior positive nursing experience.   Here's what she related to me yesterday...........

Baby was born several weeks early.  It was discovered at birth that the mother had a rare infection in her placenta.  Several layers of the placenta had literally been eaten away, and the Dr. didn't know how the baby had survived.  She was shown the placenta because it was totally BLACK.   She said the Dr. told her there were black spots on her uterus as well.    She also is a diabetic, which the Dr. thinks could have contributed to her more easily contracting an unusual infection.  The mother was treated with antibiotics, but the baby wasn't initially.

The baby didn't have much sucking reflex.  She did work with an LC at the hospital several times.  The baby even with an artificial nipple would put her tongue on the roof of her mouth and have the nipple under her tongue.  The LC ordered special bottle nipples that are very stiff to help her bottlefeed.   The LC finally told her after working with this problem, and trying to latch the baby on with a nipple shield, that she'll probably never latch on well and may never breastfeed.  The mom was determined to make it work anyways.  

For the first 2.5 weeks after birth, she was pumping (with not the greatest pump, but the same one she used successfully before) every 2-3 hours and was getting a total of 7 oz per pumping session.  In spite of that the baby was consistantly losing weight.  Finally the Dr.s decided that the baby could have contracted the infection the mother had, and treated the baby also. Mother said quite rapidly, the milk seemed to disappear, even though her pumping habits hadn't  changed.  All of the sudden, she could only get 3 oz...   then only 1 oz per session.  So she had to use formula.  She hasn't stopped pumping and says she's even gone to the LC center to use their large pump a couple times a day....   she now has sore bleeding nipples, but no more milk.  

She's eating and drinking well.  Also, the OB suggested that maybe the infection had something to do with the milk supply and put her on a course of Reglan.  No effect.  She just finished a second course and has seen no change, just lots of bothersome side effects.  She's very frustrated and very much wants to breastfeed.  She's never had the baby successfully latch on, she's very sore, and her milk is almost non-exsistant.  

Since she was successful before, and seems to be doing the right things....  do you have any suggestions I can offer?   Could that infection have done something hormonally to interefere?   She had milk initially.  I've never had a call quite like this and other than offer support and empathy, I wasn't sure what to say so I told her I'd look into it more.   She's considering giving up...   and I didn't want to tell her to..  but unless she's left something out I'm just puzzled.



Julie 

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