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Subject:
From:
Lynn Shea <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 24 Mar 2005 17:24:04 EST
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In a message dated 3/22/05 8:02:02 PM, [log in to unmask] writes:


> Weight gain of 3  ounces in next two weeks,
> at which time mom contacted me again because she felt  her milk supply was
> dwindling.  Previously she had been getting 4+ ounces  total per pumping and 
> was
> now down to 1-2 ounces when she pumped
> I advised resuming pumping after most  feeds and supplementing
with 1 to 2 ounces EBM and/or formula thru SNS and she  started fenugreek.
Milk supply increased slightly  with this regimen, but transfer
weights continued to be less than 30 cc's  total. 
Fenugreek and any feeding at the breast was discontinued last  week by
mom's choice.  Mom only getting total of 10-11 ounces per day  and giving 
about 20
to 22 ounces of formula by bottle. 

I'm unclear as to the age of the baby at this point. Clearly her supply 
dropped dramatically over the 2 wks of nonpumping BUT a milk transfer of only 30cc 
or so may have been expected with the decreased stim   AND seemed to coincide 
w/ a 50-75% decrease in EBM.   The poor transfer may have been closer to 
optimal when compared to available volume thus It is difficult to assess whether 
this baby was improving her suckle p/t it's abandonment. With this in mind and 
because suckling is preferred to pumping when attempting to up production, I 
would encourage Mom to resume SOME feeding at breast, along w/ domperidone use 
and reiteration of the importance of compression, changing positions and switch 
nursing when swallowing has dropped off. Hopefully she is skilled at all of 
the above by now! 
If the baby is spitting more w/formula than it seems safe to presume that the 
formula is the cause, I'm skeptical as to how a GI specialist can help with 
this. IME, most often they advise a more elemental formula AND discontinuing 
breastfeeding.
Lynn Shea Rn,Bsn,Ibclc
Lakewood Ranch, Fl



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