Spoke to mother today-have permission from her-who has a two week old
daughter.  Baby was born 2 weeks before due date.  Baby was born 6lb4oz
and was discharged at 5 14.  At one week check up baby weighed only 6lbs.
She bf every 3 hours.

She stated that she had an oversupply of bm and was almost engorged.
Breasts were sensitive to the touch.  She was not in pain.  No fever.  Wed
and Thu she supplemented with formula because baby had jaundice.  She has
not supplemented since then.  While she was supplementing she was pumping
with a double - the Lactina - every 4 to 5 hours.  "She tried to stretch
the time out."  She switched today to the Pump and style.  I commented
that when pumping is needed, pumping should be done every 3 hours
according to LLLI.  Babby poops at least 8 times a day.  Poops are dark
yellow, loose and watery.  Wet diapers are about 10-12 day.  Mother said
that she is not sure about the # of poops and wet diapers.  I advised her
that a wet diaper should feel like 3 tablespoons of water.  Up until
8:30PM mother bfd 6 times in the day.  Mother bf at night but does not
cosleep.
On Thursday, after pumping her nipple "puffed out" and she saw a blister
but it sloffed off.  There's nothing there now and there's no pain.

My suggestions to her were:
1) breast massage
2) warm and cold compresses between feedings
3) pumping after feedings
4) expressing some milk before feedings
5) try to feed often.  watch for baby's feeding cues - eyes flickering
when asleep and body movements.
6) referred her to a local la leche meeting which she is going to try to
attend
7) recommended a good LC in her area

What do you recommend and is there something here that I'm not seeing.

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