I'm working with a mom with low milk supply and thought I'd run it by all of you to see if I'm missing anything. First baby, 32 years old. 18-hour labor, 2 1/2 hours of pushing, vaccuum and forceps tried, finally C-section (is it just me, or is anyone else seeing more of these horrific labors lately?). No meds in labor, spinal for C/S. Baby weighed 9-7 at birth, down to 8-3 at 6 days. I saw them at 7 days. Very educated, knowledgeable family, good support system, mom very motivated. No sign of breast fullness. According to mom, baby nursed well, long and often from the start. No sore nipples. Baby well-attached at breast, swallows well for a few minutes, then stops swallowing, shuts down, wakes and fusses when taken off. Typical inadequate intake scenario. Had been given a little ABM, not too dehydrated. The only clue I could find is that mom said she "lost a lot of blood" during birth process. Has anyone had any experience with this? If this is indeed related to large blood loss, in your experience does the milk supply ever increase? I set them up with an SNS, which seemed to work well for them. Also a hospital-grade pump. Baby is now gaining well. They later went to see hospital-based LC for trouble-shooting SNS difficulties. I talked to dad today, and baby is taking 3 oz. per feeding with SNS. When mom pumps, she still gets less than an ounce. I have been in consultation with hospital LC, whom I know, and we have both encouraged mom to do whatever combination of SNS use and pumping she can handle. Any other suggestions? Much appreciated. Miriam Levitt RN, IBCLC<[log in to unmask]