I have a new baby, now 5 days of age (born 9/12/03) at 38 5/7 weeks to first-time mom. Labor was spontaneous, mom had 1 dose of IV narcotic during labor, delivery was not instrumented. Birth weight 6 lbs 10 oz (3010 gms.) Baby latched well, but was noted by mom and nurses in the hospital to have just brief periods of rapid sucking, then to fall asleep. Baby did have a circumcision performed with local anesthesia at about 18 hours of age. At 44 hours of age, he was also evaluated by our IBCLC, who reported to me that the baby roused easily and nursed actively for about 20 mins during her consult, then fell asleep. Mom could express colostrum, and baby passed several meconium stools and voided 4 times the day of discharge (at 48 hours.) Discharge weight was 6 lbs 1 oz (2760 gms) After the LC saw him he had one more feed that mom reported as good, active sucking for 20 mins prior to discharge, so we thought he was starting to feed well. Mom was given a follow up appt in 48 hrs and advice on keeping baby awake, lots of skin to skin, feeding on cue, etc. I saw him 48 hours later, and mom reported no stools since hospital discharge, and baby was again falling asleep quickly at the breast. Weight (now at 4 days) was 5 lbs 12 oz (2615 gms.) Baby was alert, latched well in the office, but again fell asleep quickly. Mom can express drops of colostrum, but does not feel her milk has come in, and breasts are soft. He did not appear jaundiced or dehydrated, but given the weight loss, the ineffective feeding behaviour, and poor output, we started a plan to supplement (finger feeding or by cup) continue nursing as baby is willing, and pump after feeds during the day. Any milk pumped will be used to supplement. 2 questions: Mom asked me if any galactogogue would be useful in this situation. She had heard of fenugreek. I'm thinking the problem here is more baby unable to move much milk, along with perhaps a bit delayed mature milk supply, so I'm thinking a galactogogue would not help? Also, there is no convenient pump rental station here (we're hoping to perhaps start one when we finish a labor and delivery remodel sometime next year.) This mom only has an Avent Isis hand pump. She is able to get small amounts of colostrum with it. There is a pump rental station about half an hour away. Is it important that she get a good double pump for at least the short term? Unfortunately this mom does not qualify for WIC so cannot see the IBCLC again so she has to settle for me! She is very committed to breastfeeding (in fact commented that she wasn't even going to get the Isis since she was planning to exclusively breastfeed and is a stay at home mom. She got it as a gift.) Jennifer Tieman Family Physician Mom to 4, including nursling Caroline Rose born 5/31/03 *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html