Given that pumping is an issue for this mom,  how to
>maintain the supply is an issue.  Will ask about hand expression tomorrow,
>but with two toddlers, even the sns is seeming overwhelming to her.

Lori, I had a client whose baby wasn't gaining and who couldn't get milk
with a pump unless she used breast compression at the same time.  We
concluded that her milk sinuses were located farther up on the breast than
her baby or the pump flange could reach.  So she single pumped and
compressed her breast, or she compressed throughout the feeding and all was
well.

Pat Gima, IBCLC
Milwaukee, Wisconsin
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