At this point I would suggest she spend at least 24hrs with baby S2S in
the biological nurturing position and BF every time baby peeps, shows
hunger cues or just feels like sucking. If he gets frustrated, give him
some nourishment by bottle (about 1oz) to give him more strength to
suck, then back to the biological nurturing position.
Larisa
-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of brooke
Sent: Friday, December 10, 2010 10:48 AM
To: [log in to unmask]
Subject: low milk supply, where to start?
PTP. I got a call from a woman this morning and will see her
this evening. Sorry for length, but wanting some feedback on
what your plan of action would be at this point to prioritize
protecting milk supply, feeding baby and helping an overwhelmed
Mama before she gives up. Sorry for gaps in info (infant output,
etc)...she had to get off the phone...
Baby born December 1st, 36 +3, Birth wt: 5# 10 oz, Current wt:
5# 4oz and gaining, Lowest wt: 5# .4 oz (on day 6)
Mom's first baby, no known maternal health issues. During pregnancy
there was some concern she might have a variation of preeclampsia.
BP stable but elevated liver enzymes two weeks in a row and
something else abnormal on liver panel. Liver "clearly not functioning
well." Water broke spontaneously at 36 weeks and she was induced
with Miso and Pitocin. Mom also given IV w/ penicillin and ampicillen.
Had a rash postpartum across abdomen and breasts which doctors
thought was allergic reaction to abx, has gone away. Baby born
vaginally, stayed in hospital one week for treatment of jaundice.
Mom reports "not much change" in breasts during pregnancy, some
increase in size. At hospital when milk came in, and she was
able to pump 20 ml per session both breasts, experienced engorgement.
But even then, she "didn't feel like all ducts were present or
open" when she massaged her breasts. Now breasts feel soft.
Came home, baby was "lethargic" for two days, now mom reprots
she's thriving, energy increasing each day with weight gain.
In hospital, LC's were impressed that 36 weeker had such a good
suck. What she's currently doing:
Hospital LC's taught her to use SNS and to finger feed formula
so she is supplementing at breast. Baby taking 2 oz formula
5 times a day, and 20-30 ml at other three feedings for a total
of 8 feedings. Plus small amount of mother's milk she's expressing.
Hospital wanted baby to get: 40-60 ml, 8 times a day. Baby suckles
directly at breast for little spurts throughout the day but mom
is convinced she's not getting much if anything and reports her
nipples are "huge" and baby is tiny.
Was pumping after every feed at hospital, now just five times
in 24 hours. Gets 5 ml total each time when double pumping,
using a Medela home pump (not sure model but not hospital grade).
Drinking mother's milk tea throughout day and a single bottle
of beer, taken in small sips throughout day. Eating soaked fenugreek
seeds by the spoonful. Just started Chinese herbal formula and
is going to get an acupuncture treatment this morning.
Mom is motivated, educated, wants desperately to have baby on
breastmilk only but is feeling exhausted by SNS, pumping, etc.
Overwhelmed. Open to pumping more frequently with hospital grade
pump but struggling between "should I sleep, should I gaze into
my baby's eyes, or should I put the baby down to pump my breasts?"
FOB working full time.
Thanks, wise ones,
Brooke Casey
New IBCLC, LM
--------------------------------
Compassion is the deepest form of memory.
--Eve Ensler
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