I appreciate and agree with the discussions about early on problems
affecting supply later...so can someone offer some specific strategies for
rebuilding the supply? I have a mom (~4 mo) who has been battling supply.
She had early latch difficulties and that may have led to the problems she
has now.  I will be seeing her on Wednesday.  Via telephone, we have tried
fenugreek (last 3 weeks), breast massage, expressing (hand pump) after
feeds, and switch nursing to keep the baby interested (baby stops, cries,
and refuses breast when let down over).  Baby feeds for about 30 minutes
every 2-2.5 hours on cues and sleeps for 6-7 hours at night.   Mom still
"needs" to give ABM up to three bottles per day.  Infant gaining adequately.

  We plan to try the following (in addition to reassessing latch,
positioning...):
1.  breast compression
2.  upgrade to rental pump and do double pumping after feeds and once during
night while baby is sleeping
3.  any supplemental feeding will be with a tube at the breast to keep bf
longer before switching sides.

 Any other ideas (other than reglan-which I will discuss with her tomorrow
as well)?  Mom used to pump easily, but now only gets a few drops after
feeding--if pumps instead of feeding it takes 15 minutes to achieve let down
and then gets about 2 ounces.  Mom is not on any other medications.  Mom is
"high stress" so I may suggest hypnosis as well.  Thanks in advance for any
help.

Judy :-)
Judith I Rosen, RNC, MSN, CLC

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