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Fri, 5 Apr 2024 13:24:38 -0400
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I just got thinking during a recent conference that therebis a propensity of us long time, lactnet originals, first LLL IBCLC’s, that are presenters still. I rarely see a younger LC in this role. What will happen as we all retire as I just did from my Breastfeeding Coordinator role at WIC (still there as an LC)? Who will deliver this awesome information to newer LC’s? I’m concerned 😳

Warmly and still with passion, 
Ilene Fabisch, IBCLC/RLC

Sent from my iPhone

> On Mar 10, 2024, at 12:00 AM, LACTNET automatic digest system <[log in to unmask]> wrote:
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> There is 1 message totaling 74 lines in this issue.
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> Topics of the day:
> 
>  1. unresponsive to pump
> 
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> Date:    Sat, 9 Mar 2024 11:57:15 -0500
> From:    Margaret Wills <[log in to unmask]>
> Subject: unresponsive to pump
> 
> Dear Lisa:
> 
> This is indeed a difficult situation, and and you're digging deep in the
> toolkit!  Were there any clues in the small improvement she noted? 
> Women have very individual reactions to a pump, and sometimes it helps
> to track what exactly seemed to play into the better sessions.  What
> made her feel it was an impending plugged duct when it resolved with
> gentle massage in the next feeding, rather than just a full area?
> 
> Other pre-pumping prep ideas -- pumping after a hot shower, leaning
> forward, with the breasts hanging free and doing a jiggly "milk shake"
> massage, with quick finger-tip tapping around the breast, wakes  up the
> nerves and mobilizes  the milk forward (and this may somewhat increase
> the pumped milk's fat-content by loosening the fat globules on the cell
> walls).  And maybe do a little preliminary nipple stimulation and
> hand-expression into the flanges before positioning them on.
> 
> It's useful for her to see hand-expression that really shows squirts:
> 
> https://www.youtube.com/watch?v=Fs-WEgrLJF0&list=PLoaoJf2DnVbkxeSOkQ_pMuTtN2B6f9PnR&index=7&t=13s
> 
> https://www.youtube.com/watch?v=Fs-WEgrLJF0&list=PLoaoJf2DnVbkxeSOkQ_pMuTtN2B6f9PnR&index=7&t=13s
> 
> Hand-expression is a great skill to have, and if she just needs a few
> ounces for occasional separations right now, it might help her feel like
> she has a backup plan while she's figuring out the pump.
> 
> Is the return to employment and the increased need for the pump
> happening soon?  Is that adding to the stress?
> 
> Even if her personal-use pump, a reputable brand, is functioning
> optimally, would she be able to try a short-term rental of a actual
> hospital pump? (Every pump sold bills itself as "hospital grade,")  Even
> if the suction levels aren't different, a rental pump's bigger,
> sometimes quieter motor with a smoother, steadier pull and gentler curve
> on the suction release, seems to make a difference to some pumping
> mothers.  And a different machine doesn't have that association with
> frustration.
> 
> Good luck to all.   Let us know when there's the breakthrough -- it's
> always informative to hear the end of the story!
> 
> Margaret Wills, IBCLC Maryland, USA
> 
>> Date:    Thu, 7 Mar 2024 06:14:20 -0500
>> From:    Lisa Bell<[log in to unmask]>
>> Subject: Re: Unresponsive to pump
>> 
>> Thanks everyone for your suggestions. I had her trying everything that was suggested. She did have some improvement but still wasn’t able to empty with the pump. She called me today and said that she noticed that she was developing the beginnings of blocked ducts that disappeared with massage while nursing. She is going to try taking lecithin.  Not sure if this is the cause or the result of the milk stasis but we shall see..
>> Thanks for all the help both on lactnet and with emails!
>> 
>> Lisa
>> 
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> End of LACTNET Digest - 7 Mar 2024 to 9 Mar 2024 (#2024-12)
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