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Tue, 9 May 2006 14:41:16 -0400 |
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Thanks so much for your response, Rachel.
>
> I have some thoughts about your choice of flanges. You state that
> the =
> mother's nipples are small (small in diameter?) and short. Your
> choice =
> of the 30mm, then the glass flanges and finally the 24mm flanges is
> the =
> reverse order that I usually take. I watch the mother closely
> when she =
> pumps. Occasionally I have been fooled in the past and I thought
> that =
> the mother's nipple had widened, when in reality her areola was
> sucking =
> into the tunnel of the flange. These mothers actually need the 21mm =
> size flange. I find many mothers need the 27 and the 30 mm flanges
> to =
> accomodate their wider nipples. I recommend the glass flanges to
> the =
> uncommon mom with extremely wide nipples.
Interesting! I will try the 21 mm flange. I think I only have one
in my whole inventory, because I have never used them, but maybe I
need to try them more often! I went larger because the mom
complained of a rubbing sensation during pumping. I also recommended
that she lubricate the flanges with oil.
>
> I have watched many mothers, with low milk supply, drip and squirt
> in =
> the manner that you mentioned. They are having multiple "let-
> downs" but =
> there isn't much milk to let-down. =20
The thing I don't understand is that when the milk stops coming, the
areola feels very dense and swollen, and a minute of resting or RPS
allows milk to start coming again. So I feel that there must be more
milk in there and the pump is somehow preventing it from coming,
rather than helping it come.
>
> I rarely use a 16mm nipple shield. The mother truly has to have a
> tiny =
> nipple to comfortably use it. If you "stuff" a nipple in a too-
> small =
> nipple shield it compresses the ducts and may completely occlude
> them. =
> 5 pound babies can comfortbly use a 20 mm nipple shield. By your =
> description, I would not have recommended that you use a nipple
> shield. =
Yeah, I just wanted to try everything, and based on Paula Meier's
research, I thought there was a chance that the firmness of the
nipple shield would help keep the baby awake and sucking more
actively. But there was no milk transfer, so scratch that idea!
> This baby would probably be a good little breastfeeder if there was
> some =
> more milk to drink.
Agreed :-( I am going to just demo an at-breast supplementer next
time and see if she warms up to the idea.
> You did not mention the baby's birth weight. =
5 lb 4 oz.
> Perhaps on your next update, you could also tell us if the mother
> used =
> fertility drugs or in vitro fertilization to conceive.
Yes, she used fertility drugs.
Thanks again for your time in thinking about this case.
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