Jeanne
I think you are on target with your care plan. Continue the RPS as I feel it 
is an excellent technique for these situations. You may not see results 
right away, but you have expressed colostrum already.
This mother is at very high risk of milk supply problems due to the poor 
feeding behavior of the early-born infant. I would have her lie on her back 
whenever she can, elevate the breasts for good lymphatic drainage. Perhaps 
use only hand expression 8-10x per day for the first 2-3 days and then go on 
to pump use. Ensure the proper fit of the pump flange. Perhaps use single 
pumping so that she can handle the large breasts easier. Encourage her to 
use kangaroo care. Hope you find some of the recent posts on large breasts 
helpful too. I do not recommend use of bromocriptine unless mother wants a 
total weaning; however it is possible her breasts will grow more during the 
lactation.


Laurie Wheeler, IBCLC, MN, RN
Mississippi/SE USA

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