RE: Re: Need fresh eyes, and brains, for complex case -long-

[Guest guest]

Hi! On top of what was already said,What is she pumping with?maybe worth changing the pump or check the one she has.Did you try any herbs? Adi Kiriaty. From: [mailto: ] On Behalf Of angela_hartfelder_ibclcSent: Tuesday, June 05, 2012 3:30 PMTo: Subject: Re: Need fresh eyes, and brains, for complex case -long- She seems to be adjusting well, though she has always been on the upper limits of normal anxiety wise, both before and after pregnancy both times. Possibly more right now, because she is very frustrated about having lots of milk last time 10 ounces a day this time. She understandably wants to do whatever it takes to bring in a full supply, and she wants it now. I'm a little frustrated trying to figure out what has made such a huge difference. She had all the confounding issues last time that would argue against bring in a supply of any amount - no stimulation until day 5, anxiety, grief, only a PIS for milk removal, etc.The big differences this time should have been in her favor. Early & often feeding, lots of ongoing skin to skin, family support. There is only one big thing I can't reconcile in her favor and that is that she was a c-section. She didn't labor at all because they didn't want her contracting with the same cord issue. Hence, she didn't get the typical hormonal flood of labor, but she would still get the withdrawl due to the placenta removal during the c-section. And it still doesn't help me to know what to do for her.Ok, history of anxiety much of her life. Terrible reglan reaction of extreme anxiety, anger, sudden depression, muscle twiches, which all resolved when she stopped it. Reglan blocks dopamine receptors, Dopamine blocks prolactin, hence her supply issues. Maybe her dopamine levels are high, and the reglan dropped her dopamine to levels she couldn't tolerate. Which begs the question of what to do next? If you drop the dopamine to increase the prolactin, you get jittery crying angry mom, if you support the dopamine, you have no supply.And, on top of all this uncertainty...she's moving to Florida for 2 years in about a two weeks. Anyone around Daytona want a new challenge (who is a very nice mother and willing to do anything!)? Hartfelder IBCLC, RLC>> How is mom doing emotionally? Having a healthy baby after losing one can> stir up all kinds of difficult emotions - emotions that could be having an> impact on mom's milk production.> > Warmly,> > Fleur

[Guest guest]

Something just hit me. Does this mother have any symptoms of hyperthyroidism or hypothyroidism? Childbirth can cause sudden inflammation of the thyroid, causing it to swing to hyper or hypo condition. My understanding is that this can happen later than the immediate postpartum period. Perhaps her thyroid levels should be checked if this has not been done. (Sorry, this thread has been going for a while and I can't remember all the details you have shared previously.)

Dee Kassing

Oh yes, she's been pumping every 2 hours since the day her supply suddenly seemed to vanish. Mom is only getting 10 ounces a day (on a good day!) and so baby is being supplemented with an additional 12 to 14 ounces a day of donor milk, and thus gaining appropriately at 20 to 30 grams a day. She is taking goat's rue, but doesn't seem to be helping. She did get her GI to prescribe the domperidone yesterday for her "reflux" and hence the pharmacy agreed to fill it since it was for that and not milk supply. Hartfelder IBCLC, RLC