Hello All,

Permission to post: I have a patient  who has had multiple bouts of plugged ducts, mastitis and damaged nipples in pumping for the last 2.5 months in the NICU for her multiples. She has used a Medela Symphony pump and felt too much pain. She currently uses a Spectra pump and feels that the pulsatile action of the pump is the most tolerable. I have been a NICU LC for 6 years and I've never had a patient with this much pain. We have tried all the usual-adjustment of flange size on many occasions (uses a 27-30mm flange) as well as use of Lanolin cream with pumping (not anymore), hydrogel pads, APNO cream after all pumping sessions and a course of 7 days PO antibiotics which is now finishing today. She uses heat before pumping and deep massage during all pumping sessions as well. (She watched the Morton videos)

She has pumped for 10 weeks and is now choosing to wean. She has been taking lecithin 4800mg daily which helped at first but is now only helping minimally. (This was started when plugged ducts initially began several weeks ago). I cannot find information if a higher dose of lecithin is safe. Please advise wise ones! Also, any other advise on the above mentioned scenario would be appreciated.

Rachel Cruz, RNC-NIC, IBCLC




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Subject: LACTNET Digest - 16 Mar 2015 to 17 Mar 2015 (#2015-118)



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