Dear Lacnetters,
I haven't posted in years. My practice is small, as I've moved on to other things but I still keep up and see on average four clients a month.
I have permission to post.
This is a telephone client as I am (impatiently) waiting for a Corona test. 7th child 4 days old, nursed the first four babies long term no problem. Baby #5 was sleepy, didn't nurse well so she started pumping and giving a bottle. The same with 6, and now 7.  She called me a few hours after getting home from the hospital with engorged breasts and no milk coming. She called me again just now with the same problem. She says she has unusually large nipples and they have been deformed from pumping so much. When the baby latches on she just holds the nipple in her mouth, does not really suck. She is not much livelier with the bottle. 
The mother and the baby do not have health problems. The pregnancy was normal and the birth normal. She did have an epidural.
She has seen another BF counselor already; she said it was useless. I suggested another but she heard she's not working because of Corona.
I suggested the problem might be with the baby and perhaps she would like to consult a CST. She said that all she wanted was to get milk out. She says hand expression has also stopped working. So I told her how to do the old fashioned warm-glass-jar-cools-down-into-a-vacuum method. (ancient history!) And a glass of wine.
She is convinced that her nipples are ruined for nursing.
She does not have access to any device that could do Zoom/Skype/whatever.
I also asked if she ever tried nipple shields and she says even the largest are too small for her. 
I am really challenged by not being able to see her! 
In addition to wanting your cumulative wisdom, this is a shout out to IBLC's in Jerusalem, Israel who are seeing clients now to send me their phone numbers so I can pass them on!
Thank you all,
Stay well,
Yael
PS Funny story. Went to a client with a large face  mask and sunglasses and "social distanced". Only after I left did I realize that I'd forgotten to take off my sunglasses so I called her back to apologize for looking like a strange robot.  It must have been so weird for her!

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