Hi, All: I'm currently working with a mom (permission to post) whose baby is 4 weeks old now. At 2 weeks of age, mom called me stating she didn't think baby was satisfied at breast. Baby still had mec stools but peeing OK. I had her run, not walk to MD where weight showed same as d/c weight. At least baby hadn't lost, but obviously no gain either. I got her pumping, but she reported no significant increase in milk. At breast, baby latches well, but never kicks in to rhythmic suck/swallow - seems to not be stimulating regular let-downs. Some milk transfer noted, but obviously not enough. Mom's history is gastric by-pass a year and a half ago. Got pregnant less than 3 months post-op (much to horror of her docs, who advised waiting a year), had normal pregnancy, but rough delivery. When I saw the baby again at 2 weeks, large unresolved hematoma still present on back of head from vacuum delivery. Facial bruising from attempted forceps resolved by then. I feel the baby has dysfunctional suck related to traumatic delivery and asked the mom if she would be willing to have baby evaluated by chiropractor. This is not an option as she stated she knows 2 people who have had very bad experiences and her husband (from Ivory Coast, Africa) would not agree to this. Our speech pathologist has agreed to do a feeding eval on baby next week. Meanwhile, mom continues to nurse baby every feeding, and supplements with EBM/formula prn (not every feeding, mostly at night). She has been using Mother's Milk tea and last week started fenugreek capsules. I talked with her yesterday and she states she has only been using 1 suppl. bottle/day the last couple of days and that she is getting more milk with pumpings. Baby seems more satisfied now after feedings. My questions are: Her doc doesn't think Reglan or domperidone are appropriate for her with her history of by-pass surgery. Makes sense as these are gastric medications and may increase any dumping syndrome she may be experiencing. The ped was also concerned about possible side-effects in the baby. The mom said he told her he sees a lot of "side effects" in babies whose moms are taking Reglan - what I don't know. I will ask him next time I see him. Have any of you encountered "side effects" in babies to the point where you would hesitate to recommend Reglan? I haven't, so am mystified. Also, has anyone worked with a gastric bypass mom who is experiencing breastfeeding difficulties that seem to relate to her surgery? I suspect we will be seeing an increase in nursing moms who've had bypass surgery, as this becomes a more affordable option for women. Thanks for any input. Pam Hirsch, RN,BSN,CLC Clinical Lead, Lactation Services Advocate Good Shepherd Hospital Barrington, IL USA *********************************************** 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(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html