Re: << I have been working with a mom in our SCN who delivered triplets 17 days ago. She has been pumping with the Symphony pump, and has had low milk
output from the beginning. We finally are getting her to pump 80ccs at a
time, after several days of power pumping. This puts her overall daily
pumping volumes at about 640-700cc per day. >>


How often is she REALLY pumping every 24 hours. (I find there is often a disconnect between how often they say they pump and how often they actually pump.) How long is she pumping per session or what is her pumping routine? I'm assuming she's double-pumping per the lit that finds greater volumes (at least once lactogenesis II begins) with double pumping. 


<< Seeing as how 700cc is the normal amount a mom would be wanting to pump
for a single baby, I am wondering if we should be concerned enough to
start this mom on Reglan. If anyone has ever recommended this for a mom
with multiples, please let me know. I am probably going to recommend
that she start sometime next week. >>

As you note, she is producing essentially WNL and it is unlikely that she is pumping 3x as often as the mother who gave birth to a single infant. Reglan has potential side effects, including a higher incidence of med-related depressive episodes. Some evidence indicates that mothers of multiples are2-3x more likely to be affected by PPD, so that should always be a consideration. 

If she maintains pumping via a good protocol for at least 8x per day, production will probably go up once babies are able to transfer milk via breastfeeding. (I realize that may be fairly far down the road depending on gestational age and any other complications related to/more common with higher multiples.)

Karen

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