Thanks for the input so far ladies. I am going out there to see the family shortly. I am always leery when a nipple sheild is put in without someone to evaluate the use! Not to mention I am very concerned that there is a continued tounge tie. So hopefully I can either figure it out, or convince them that they do need to see someone else. 
 
The mother has actually already tried hand expressing, I suggested that earlier this week for a number of reasons. She has so much exisiting nipple trauma that hand expressing is near impossible and extremely painful. 
 
I discussed last night with the CPM that she may need to pump, and that is a possibility. However, the other amish families in this community that I have seen do not have running water. I was completely embarrased when I asked to wash my hands before looking at a baby-they had 2 gallon jugs of water for the day-for everything. Just another one of the things making this tricky.
 
Please correct me if I am wrong-I had always heard that applying drops of breastmilk to a cracked nipple and allowing it to air dry was a way to aid healing and ward off infection b/c of the natural properties of the breastmilk? Obviously not rubbing it on, but just a few drops to the affected area? Money and natural intervention only is of pretty high importance here, so I often find that if I suggest something more 'traditional', like APNO even, I can 'loose' people.
 
Thanks
 
Really hoping there is some simple, bizarre explanation for this trauma...



      

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