Will introduce myself - am LC working at a hospital in Calgary, Alberta
Canada - have been assisting BF mothers for quite some time
Have very interesting case at present and would value your input
Lady delivered her second two days ago -- stated she did not have milk with
first baby -
History
no breast trama
menarche 13 years of age along with breasts containing whitish fluid that
appeared as drop whenever she "squeezed" breasts - but no active dripping
Fam Dr. at that time did Prolactin level and it was very high - does not
know what level was - Always has had fluid in breasts since menarche

First pregnancy @ 26 years of age(2001) - delivered female 10 days before
due date - uneventful back labour lasting 18 hours
thick mec at birth so didn't get baby to breast for four/five hours after
birth - breastfed only - on demand -
At 5 days Community Health Nurse visited - mom worried re baby fussinig -
talked with LC - thought milk not in yet - was advised to continue breast
feeding - never felt sensation of breasts filling or being full - states
breasts have always felt "soft"
Feeding pattern with first baby - 1/2 hour each side
Mom states for 6 weeks she only breastfed the baby - and baby was on breast
very frequently
-baby output - lots of wet diapers - small amt green  stool every third day,
weight gain satisfactory
At six weeks grandma came over with breast pump and after pumping each
breast for one hour - she got 0 milk - so immediately put baby on formula
as she assumed she had no milk
She desparately wants to breastfeed this baby and has asked for help
Present baby - bf within first three hours  and frequently throughout second
day (X11) - have assessed three feeds - hace seen sustained and deep sucking
and hearing swallows - day 2/3
Complicating factor - has given similac sups (X1-  evening following birth
and X3 - second evening/night) due to feeling baby not getting enough and
frucstration with baby fussiness at breast - uric acid crystals in urine
morning day 3

After reviewing all the info - think perhaps first baby got a lot of
foremilk- little/no  hindmilk - thus the fussiness and lack of
stool - have reviewed with this lady and she is going to try one breast per
2-3 feeds - watch output particularly quantity and frequency of stools
Would value any further input from all of the experts - thank you in advance
Mary-Jane

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