I was hoping that someone could help me figure  something out. I am trying 
not to overlook anything nor am I trying to create a  problem where there may 
not be one. I have permission to post.
     I had a mother call our office the other day with  a question about her 
milk supply. Her baby is 11 weeks old and within the last  week or 2 has 
started to nurse from each breast for only 3-5 minutes. When she  returns him to 
the breast for any longer time frame, he fusses and cries.  Shortly thereafter, 
he can be soothed and is happy for another 1 1/2-2 hours  until the next feed. 
So she started pumping with her Pump N Style after feeds  and had an output 
of 1/2 oz. The baby sleeps 7 hours at night.   Ten days ago, she called another 
LC who is in her peds practice and that LC  recommended fenugreek. She did 
note a smell of maple syrup but no increase in  her supply. She had noted 
occasional green stools from the baby but an  increase in those, along with 
fussiness and gassiness. She also admits to a fast  MER.
    I had her come to the office so I could observe a  feeding. The baby did 
what she said--ate for 3 minutes each breast then stopped.  He would pull of 
the breast, fuss, return for a few sucks and the fuss some  more. Eventually 
she calmed him and he was a very happy baby. No arching seen.  His birth weight 
was 7-11 with steady weight gains each week or month seen. His  current was  
12-5 which was an appropriate weight gain since birth. I  did a pre and post 
feed weight and this visit, he took only 1.1 oz. 
    I tried to reassure her that babies at this age are more  effective 
eaters and don't spend as much time at the breast as they used to as  newborns. He 
is very developmentally appropriate, maybe even a little ahead of  the curve. 
She rented a hospital grade pump days before she came to see me. I  
recommended that she discontinue the fenugreek as this may be increasing the  baby's 
fussiness and green stools. She is to return in a week for a follow up  weight 
check. I did not see any reason to discontinue the pumping and we  switched her 
herbs to More Milk, without the fenugreek. 
    I can't say without that weight check if he is one  of those babies that 
lives off mom's MER and good supply. His weight gain is on  target and not 
excessive that would made me think over abundant supply. I truly  feel that she 
is worrying about nothing-she and her husband both admit that they  tend to 
overreact. I explained to her that it is not unusual to get 1/2 oz with  pumping 
after a feed. She has not supplemented with any formula. When the  parents 
have offered the occasional bottle, he will take 4 oz.  
    I appreciate any words of wisdom, points of view.
 
 
 
Allyson Michaels RN, IBCLC
Charlottesville, VA
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