"Abandon the pump along with the formulae"

I advised this Mom against pumping throughout the 1st 2 phone calls. Since
this was what the dr. told her to do (and the dr. told her to give formula
to 'help jaundice') she insisted. And she was happy with the short term
result (Dad could give baby a bottle at night and she got 4 hours sleep). I
KNOW this will make you scream but I find it very hard to insist Mom not do
something she is set on. If I went and told her 'abandon pump and formula',
she would probably abandon ME and not call back.... (incidentally the pump
DOESN't hurt her nipples)

"My pain nerves jangle at the thought of using a pump on cracked nipples
Most Australian midwives would agree.
Why use a pump when the baby is getting sufficient milk.  What is the
purpose?  Hand expression is better but equally may damage the breasts as
pumping would.  Contamination is worse with pumps than hand expression."

Purpose: 4 hours sleep (see above) (other thoughts - better she pump than
give Dad more formula to give the baby at night...; and, if I tell this Mom
to hand express she will faint)

"  Abandon  breastpads"
she's not using breastpads - breast shields under bra - again, she insisted
she wanted them - i 'forgot' to take them the first time I saw her and she
sent her hubbie to me 2 days later...

"I  would urge against abandoning the doctors order without first
establishing whether there is thrush in babies mouth and anal area or that
the mother has it."

I admit I was worried about suggesting she suspend nystatin for one day
since the dr. suggested it - but she told me the dr. had found no thrush,
only told her to apply nystatin 'as a preventative treatment'. At the time
I saw her she'd already been applying it for a week. Since dr. gave her all
those other peculiar orders, and this seemed to be the only one she was
willing NOT to follow, I risked it....

The latest on this Mom is that at 2 1/2 weeks postpartum baby feeds every 2
hours, and Mom reports that 60% of feeds are now bearable and she no longer
dreads nursing. Still I am concerned about ineffective suck and offered to
refer her to someone with greater experience in suck problems, but she
wants to stick it out a little longer since she believes things are on the
upswing.... thanks for your suggestions, hope weight gain continues OK and
we are out of the woods....

Anne