Hello Fellow Lactnetters. Where is Peter Hartmann when you need him? Seriously - I have permission to post. I am leaving for vacation in 2 days and am working with a mom I'd like to assist prior to my leaving.... This gr 2 mom with hx of poorly functioning left breast last time, leading to early weaning. At taht time we thoough it was an ineffective pump. This delivery the breasts appear similar in size bilaterally, but with a fairly rigid nipple base and now extreme firmness.. Left nipple is much larger than right and is Mom is now using a 30mm flange and a Symphony to assist with breast emptying. This baby born last Saturday had complications r/t ABO issues and was mildly asphyxiated at birth, both of which complicated early feeds at breast. Baby remains sluggsih at breast and refuses the left breast entirley, but nurses very well on the right. Mother has NEVER pumped more than 5 mls from this left breast despite extreme firmness, unrelieved by RPS, ice, heat, cabbage and gentle massage. She had one episode of pumping thick stringy milk, but now just normal appearing colostrum. She is in fairly severe pain and I hesitatie to continue pumping without milk removal. No evidence of mastits. She denies sports injury, compression injury, surgery, etc. Nipple looks slightly crusty, consistent with dried colostrum. I spoke with OB - who ordered an ultrasound to r/o stenosis or obstruction or tumor and all was negative. The radiologist was at a loss to explain this to mom. I'm wondering how conclusive this testing would be for outright obstruction of the nipple pores. At this point, I am steering the mother gently towards unilateral feeding, but I sure would like to give her some answers. At a loss, and of course this is someone I know personallyy and would like things to go very well for her.... LuAnn Smith RN, BSN,IBCLC York, PA On a cold winter's night! of 12 degrees and heading lower! _________________________________________________________________ Search for grocery stores. Find gratitude. Turn a simple search into something more. http://click4thecause.live.com/search/charity/default.aspx?source=hmemtagline_gratitude&FORM=WLMTAG *********************************************** 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 email list is powered by LISTSERV (R). There is only one LISTSERV. To learn more, visit: http://www.lsoft.com/LISTSERV-powered.html