Two items to discuss this am. I'd like input on some ideas for working with a local ped whose big focus is "selling" pumps from the office. I am meeting with him to discuss why he needs a knowledgeable professional to see his moms and advise what they need before it just becomes a big book keeping mess along with a case of pumping instead of breastfeeding. (He was going to hire a "la leeechy lady" to do this. ;-) His staff is NOT interested in this added responsibility. I have had some excellent input from a good friend (Hi KSC!) who worked for a Peds practice in GA for quite a while and did a great job for them. I'd be interested in any other ideas or experiences that have helped or caused a problem. The Lactina/Classic discussion is helpful too, but Mary Jozwiak might have been the person who posted about the cost and mother's perceptions. OK, three items. The comment about pit and engorgement rang true as we see it all the time. My thoughts are that it is also related to increased amounts of IV fluid as I see this in C/S and Vag deliveries, especially epidurals or inductions where mom gets mucho fluid. Jan Barger posted a while back with an excellent description of how the fluid is trapped in cellular compartments (ok I am simplifying but it's early in the morning here). Check the archives for IVs, pitocin, epidurals or something like that. Unfortunately I also see that first time moms have a difficult time with engorgement, sometimes they are the ones who get this "mismanagment" and don't know about good latch, nursing frequently and removal of fluid. They resist walking, they are in "Pain" and it snowballs on day three, when they are going home. My fiasco of the week was this scenario and she's having a hell of a time at home because her husband and mother are telling her "to take care of herself" and they'll feed the baby. She doesn't like pumping and doesn't do it often enough, was using heat for the engorgement and baby couldn't latch to a softball! Resulting in sore and damaged nipples. But she "really wants to breastfeed." Sigh.... Have a good day, Mary Kay Smith, RN, IBCLC Livonia MI - missing my Illinois friends *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html