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Lactation Information and Discussion

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Subject:
From:
"Renee Bowling RN, CBE" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 3 Sep 2013 12:55:07 -0400
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Mom has 38 week twins one month old.  Babies number 6 and 7.  Never full success with BF. She nursed on baby every 45 minutes for a year with him barely hanging on weight wise. She is currently nursing and supplementing with bottles her pumped milk or formula. The main problem that I discovered is that she only gets a milk flow with MER, and NO milk flow in between. We see this with a hospital grade pump, and also the babies will only be active during a let down, with no sucking and swallowing in between. She attempted the SNS, and does not want to try this again. History of repeated clogged ducts and mastitis with all babies. She gets more milk with letdowns if pumps one side while nursing. She is on lecithin 1200 mg 4x daily with no good results.  If she misses pumping, or takes any galactagogue, rather tea, capsules lactation cookies or Reglan(which was only with her first baby 10 years ago) etc...she immediately ends up with clogged ducts and mastitis.  Mom has very large nipples. She can pump up to approx. 3-maybe more ounces by getting multiple letdowns. The one baby is rarely nursing up to 3 ounces at a feed.  The other baby still has a hard time latching due to large nipples, and becomes overwhelmed with fast MER. She is doing some tandem sessions. Why the off switch between letdowns and how to help?  I saw the post about trying a smaller breast shield.

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