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Subject:
From:
Donna Hansen <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 12 Jun 2001 21:49:21 -0700
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Hi all,

I need some ideas and suggestions for this mum (who is beginning to get
very discouraged).

Pregnacy was normal except during the last couple of weeks her blood
pressure began to climb. Three days after EDD, her blood pressure
reached 150/100, and she went to the hospital for a likely induction.
April 30 Cervidil was applied to her cervix at about 6pm.  Labour
started just after midnight.At about 12:55pm, (midwife estimates another
2 pushes would have done it!), she went into a seizure lasting about 4
minutes. It took 3 tries of vacuum extraction, followed by an episiotomy
and then the use of forceps before the baby was born at 1:23pm. The mum
has no recollection of the next 12 hours, although she appeared to be
aware of her surroundings. Her next memory is waking up in a different
room at about midnight. It was about 14 hours after the birth before she
breastfed. They were in the hospital 5 days. Mum doesn't know how many
bottles of formula they gave baby in the special care nursery during
those 14 hours.  Baby was in the SC nursery for about 56 hours, and then
roomed in for a couple of days.

In the hospital, she was happy to be permanently attached, sucking a few
minutes, nodding off, then sucking a few more minutes. It did take a
couple of extra days for her milk to come in, what with all the trauma,
but she thought there was plenty there. However, the baby was still
losing weight by day 14 so they started supplementing with 50ml 8 times
a day, by syringe/tube with milk from the milk bank After starting the
supplementing, she gained 70g in 3 days.

When the baby was about 16 days old they started double pumping with a
rental pump for 10 minutes per side after feedings.. still not helping
very much. Right now she's pumping about 80 minutes per day (10 mins,
8x/day), but she's increasing that to 15 mins, 8x day. Pumping yields a
total of about 5 ml.

The mum thinks she's supplying about 20ml per feeding (some test weights
done early on), and the 50ml supplement brings her up to the 70ml
suggested by the Lactation Consultant at the hospital. The supplement is
through a tube while baby's on the breast. Baby seems to notice the
difference; breast with tube = more milk, less work vs. breast without
tube= less milk, so she doesn't put as much work into it when the tube's
not there, she just waits for the tube.

Domperidone (2 pills-10mg each, 4x / day) was started when baby was 23
days old.   Trandate (Labetalol) (for high blood pressure - discontinued
taking June 11, baby 41 days old) - 100mg - 2 tablets, 2x/day (had been
taking for last couple of weeks before birth)

The feeding routine takes 1 hour (or 1.5 hours) every 3 hours (ie, 2
hours between finish and starting again).. hot compresses (microwaved
"magic bag") for 10 minutes (to aid in letdown), then about 35ml
supplement of donated milk, then 15 minutes nursing per side, then
another 35ml supplement of donated milk, then pumping for 10 minutes.
The mum tries to massage the breast when the baby slows down on the
nursing, but as her breasts are fairly small, the massaging tends to
make the baby pop off the nipple. The last few days, baby is not keen to
nurse without the tube in place.

Also taking:
+ Fenugreek -  705mg - 2 capsules, 3x/day
+ Borage Oil - 552mg -  2 capsules, 3x/day
+ tincture - Blessed Thistle, Goat's Rue, Alfalfa,Nettle, Raspberry,
Fennel, Vervain - 5ml, 3x/day
+ Custom blend tincture - Marshmallow & Hops - 2ml, 3x/day
+ Natural Factors "Super Multi Plus" ( it does contain 10mg iron ) - 1
tablet, 2x/day

The thyroid is normal, as was the other things tested (testosterone and
DEAHS (?) -- those were the two hormones that were slightly elevated
when trying to conceive -- they're now showing normal), prolactin
registered high as was expected. Iron levels weren't tested.

Given the traumatic birth, the placenta was removed by the OB rather
than having been birthed naturally, and it was apparently taken down to
the lab and really "gone
over" because they wanted to check for abnormalities given the
eclampsia.

So that's the history, what else might be going on? What else do you
need to know? What are the odds at this point of bringing in a full
supply?

Donna Hansen
Burnaby, British Columbia
Canada
mailto:[log in to unmask]

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