Perhaps she'd respond better to hand expression (maybe the Marmet technique?). Is her baby latching better now?
WRT the uric acid crystals in the baby's diaper--it's my understanding that those are microscopic. Was this confirmed by testing or did she visualize something in the baby's diaper? Disposable diapers often have a powder in them that gels when wet, and sometimes they leave a residue on the baby's bottom. Forgive me if I'm way off-base here--I've seen the diaper residue myself this week and that was the first thought that came to mind when you said crystals in the diaper :)
Jen
Date: Tue, 15 Nov 2005 17:49:46 -0500
From: Debra Ray
Subject: need suggestions
Please forgive a post that is a bit lengthy. I am a recently certified
IBCLC, although I have worked with nursing dyads or many years as an OB RN.
I have a client that has me baffled and I'm asking for suggestions.
She is 28 G1,P1, baby is 5 days old, term baby, 9+#
vag delivery, forcep assist after 2 day induction
baby did not latch well on day 1, but did better on day 2, especially with a
shield (mom has OK nipples, but they were very puffy after 2 days of IV
fluid and many hours of epidural, she went home on day 3
on day 4, she called me to report uric acid crystals in the diaper and baby
not nursing but every 4-5 hours
early AM on day 5,(yesterday) she started supplementing, and baby was down
13% from birth weightat the pediatrician, who sent her back to me
Her breasts feel full, but she was unable to pump more than a few drops,
even after I switched her to our hospital grade pump.
I sent her home with a SNS (after I watched baby nurse at the breast, with
nipple shield and SNS)and instructed her to pump after each nursing.
Today, she reported by phone that she has been able to pump only about "a
1/4 inch in the bottom of each bottle" (she rented a hospital grade pump)
and her breasts still feel "hard as a rock" pumping.
Her nipples are sore with some scabs, which we removed with warm wet soaks
and lanolin prior to pumping, massaged the breasts, and I asked her again
about previous breast surgery (none).
I'm baffled as to why we can't seem to empty her breasts. Any ideas?
---------------------------------
Yahoo! FareChase - Search multiple travel sites in one click.
***********************************************
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 mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|