Fenugreek is considered contraindicated during pregnancy due to the risk of
uterine contractions. I would favor sitting down with this mother and getting
a full history of her past breastfeeding experiences; ie. time of initial
feeding, frequency of feedings, early use of hormonal birth control, history
of thyroid dysfunction, were there any changes in her breasts during the
pregnancies (enlargement, increased sensation, darkening of the areola,
etc.), did the babies have any oral abnormalities/sucking problems, were the
babies hard to wake for feedings, early supplementation, labor medications
and interventions, sore nipples, extreme engorgement, etc. Then devise a plan
with her to make it more likely that she'll be successful this time. Go over
the basics of getting off on the right foot. Most moms who follow those do
fine. Even when a problem arises, if the mother seeks the right kind of help
early enough she most likely can work through it and preserve breastfeeding.
Having a plan should make her feel more confident and empowered to be able to
do something preventive and positive. I also like to get moms involved in a
mother-to-mother breastfeeding support group during their pregnancies so that
they'll have a support system already in place before the baby arrives.


Becky Flora, BSed, IBCLC

Kingsport, TN

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