>>Has anyone considered  unusual ductal or rather sinus structure when
working with mothers who have difficulty lactating? I feel like our pumps are
not giving us enough variety in tunnel shape and size availability,<<

Great question! I've had my share of mothers for whom *no* pump worked well.
These moms have large, saggy type breasts, very soft, and don't get much milk
with the pumps unless they are simultaneously massaging or poking at their
breasts.  It does seem that some moms have sinuses that are located higher
up, sometimes not easily reached by a newborn, and the lack of drainage
results in poor milk supply.  Compounding this is problem is that many of
today's mothers are not interested in learning hand expression, the only
method that adequately milks them, and so they do often end up "throwing in
the towel".  I would love to see someone-- one of the pump companies-- take
on this challenge and design a couple of flanges for these hard to milk moms.


Another hard to pump mom is the one with rather firm, upright breasts, often
dense from fibrocystic changes.  The baby seems to do okay, but the pumps
just don't seem to be able to get into the tissue enough to compress the
sinuses, which are either "shielded" by dense tissue or buried a little
deeper than usual.  I know that years ago there was a pump (whiting?) that
was developed that actually had more of a mechanical action in pumping; it
was rather larger, but reputedly worked very well. Chele Marmet has slides of
this thing, and with some of these more difficult cases, I do wish I had one
of them on hand!  Someone needs to go back and find out what that designer
did and try to apply that technology to the problems we still do see.

-Lisa Marasco, BA, IBCLC