>My questions are :
>
>What else could cause this low milk supply?
>
>How else can I help her increase the supply? (Didnt recommend pumping
>bacause baby nurses so much)

Cindy,
I agree with your suggestions for this mum. Just a couple of other thoughts
from my experience:

I have seen mothers with very high sinuses that the newborn baby is unable
to reach efficiently, even though their attachment looks good. This results
in inefficient drainage (and lack of fat-rich hindmilk getting to baby) and
dropping supply. Do you think this could be a possibility here? The baby's
output sounds like he is getting mostly foremilk (almost enough wet but not
nearly enough dirty nappies).

I would suggest that she doesn't spend all day feeding (this is not being
efficient, it seems), but to feed for a limited time each feed (eg not more
than about 30-40 minutes, preferably 'switch-feeding' to maximise volume of
intake, and use breast compression), then give other milk (EBM preferably),
as much as baby seems to need to settle, and then express any milk she can
get for supplement for next feed. Or if she finds SNS OK, use supplementary
milk in this, but still express after the feed to help provide the supp for
the next one. I agree with Coach Smith's rule, that number one priority is
'feed the baby', whatever that takes.

Sometimes even pumps don't work very well with high sinuses. Hand
expressing may be better at really draining the sinuses well.

******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask]
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