I'm re-submitting this since I've received no responses and would really
appreciate input-thanks. It seems weekend posting doesn't get the attention
that posts during the week do. Any resources for mom below would be
appreciated (moms who've BF on one breast exclusively).
Dear Fellow Lactnetters,
Would appreciate your input on increasing milk supply for a mom with a 7 day
old infant who had lumpectomy for breast cancer in 2000 with radiation and
chemo. The treated breast, R., is not producing and did not undergo changes
as her L did during pregnancy. Initial supply on functioning breast produced
infant wt gain WNL but then faltered with infant wt loss so currently
supplementing at breast with EBM and ABM as what she can pump is
inadequate-20-30 cc an hr after breastfeed. I have her using a Medela
Lactina but only puming on L, single pumping. She's only been doing this for
past day and a half so perhaps there just hasn't been enough time to
ascertain possibility of increase but I don't want to let too much time go by
if there is something that can be done to more rapidly increase.
Baby was jaundiced peaked at 16 or 18, can't remember exactly but since
intake increased with supplementing, bili going down. This seemed to effect
his sucking as he's somewhat better, more efficient at beast, and definitely
more alert. He was small at birth, 63, 4 oz at 40 wk gestation and a slow
feeder needing lots of stim/breast compression to keep BF with milk transfer;
he fed fine with supplement at breast, tho, good rhythmic swallowing,
coordinated. This is what makes me feel if supply can be brought up he'll do
fine; some fine tuning over time will probably be needed, I realize.
So, is there something in regard to pumping that could yield more milk?
She's on More Milk Plus, we've discussed Goat's Rue and Domperidone, as well,
and come tomorrow will see if one of these indicated. I suggested moist heat
while pumping and this am suggested stimulation of L nipple as well as R
(functioning) prior to pumping to elicit MER. I have her pumping for about 5
min immediately post feed to "empty" breast and then a more thorough pumping
of 10-15 min an hour later per Hartman's newer info re milk synthesis. Would
double pumping provide more stimulation thus increase in output even tho R
breast non functioning? This thought nags me as I've seen moms who single
pump increase dramatically with double pumping. Mom did say she had
sensation in R nipple/areola and so my suggestion to stimulate both nipples
prior to pumping.
Baby, by the way, on Fri eve able to get 34 cc after an hour of intermittent
breastfeeding with much breast compression and stimulation/relatching to keep
feeding.
Sorry so long but thanks for any suggestions-just don't want to miss
something she could be doing. The other factor we've discussed is that since
her baby's birth he's had to be seen by pedi for wt and bili checks daily so
ppoor little guy and mom have been under a bit of stress, to say the least.
Skin to skin is always in use.
Barbara Latterner, BSN, RN, IBCLC
Brewster, NY
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