I had somewhat the same situation recently, except that the mother was 12
days pp and we were trying a Lactina Select.  Still only drops, yet her
breasts were full and lumpy , basically engorged.  We could hand express
much more than we could get by pump (only drops) but it was taking too long
even to hand express.

I ended up casting around and got in touch with the local Whittlestone
distributor who lent us her demo pump and gave us a new kit and it actually
worked with this mother.  She is able to pump well now, getting more than 2
oz at a pumping session.  (It has been over a week since she started using
the Whittlestone)  She has tried her Nurture III a couple of times in the
past few days and still gets nothing when using it, but with the
Whittlestone she does fine.

This experience just showed me that different pumps work better for
different women.  I suggest trying a different type pump than the PIS, or at
the very least trying a Lactina or Classic vs. the PIS.

Regards,
Cindi Swisher

> Sent: Monday, August 11, 2003 10:00 AM
> Subject: Flat nipples and expressing milk
>
>
> Hi all,
>
> I have been working with a woman who has large breasts, flat
> nipples and is recovering from an unexpeceted cesarean (no
> other meds during labor).
> At 5 days postpartum, her milk has yet to become plentiful.
> Baby is having trouble latching (receding chin, and lifts
> tongue up).
> While we *are* making progress on latch, it is protecting her
> milk supply that is concerning me (and her) more.
> Both with hand-expression and the PIS, she is expressing very
> little milk. Hand expressing was more effective yesterday
> (day 4) that the PIS. Her nipples are not being pulled into
> the flanges (one side is a bit better), and what milk does
> come out (1-2 drops in 5 min.) does not even make it into the
> flange and hence bottle. Needless to say, at this point baby
> is being supplemented with formula by cup.
> She has no hx or indications that she would not have a normal
> supply.
>
> Ideas?
>
> ~Virginia Bobro
> IBCLC, CD

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