I thought Ann Perry's and Jo-Anne's comments about this case were excellent.

I had the same reaction as Ann - it seemed to me that the mother was
producing enough milk based on the single feeding at 3 weeks and the weight
gain. It is clear that there are lots of issues going on beyond
breastfeeding. It sounds to me that the mother is, among other things,
feeling overwhelmed by the challenges of caring for both a toddler and new
baby.

I recently worked with a mother who, when she first called me, had never
been able to get her week-old baby to latch. She was pumping 2 or 3 times a
day, giving the baby her milk and making up the rest with formula. Not
surprisingly, her milk supply was fairly low. With my help, we were able to
get the baby to latch, but it was clear that increasing milk production
would need to be a priority. She said that she found it too hard to get the
baby on the breast when I wasn't there, so she continued to give pumped milk
and formula when I wasn't there.

Despite three home visits from me and several phone conversations, I was
never able to get this mother to pump more than two or three times in 24
hours. We would talk about why this was important, and she would agree, and
when I would call her back she'd say that she just didn't have time to pump.

I knew that there must be problems and other issues, but the mother, while
very pleasant and friendly, was not interested in talking about things. She
eventually decided to just go to formula. This situation was frustrating to
me because I could not seem to figure out what was going on and why it
wasn't working. I suspect Mary is feeling some of that same frustration.

Teresa Pitman
Guelph, Ontario

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