Help!!! fellow lactnetters.
1 mo. ago I wrote re: mom with nausea, dizziness, sleepiness while pumping for
hosp baby born 12-24-95 at 30 weeks gestation. Birthweight approx 4# 5 oz. Baby
d/c/d fro hosp. 1-21-96. Mom pumping 4x/day with poor results total
10cc/session., supplementing with Neocare.
(1/31)Home visit observations: mom has a butterfly shaped keliod (scar) tissue
below sternum area, in middle of chest, brownish red in color. States due to a
bite from a "grillo" (cricket) in Mexico at age 11, which became infected. At 12
yrs reoperated due to inflammation. 5 years ago while still in Mexico treated
with "gases"(Spanish name) , perhaps frozen nitrogen, to reduce repeated
inflammation. States treatmenat was so painful, caused dif. breathing. Also had
breast inflammation frequently before and during pregnancy.
Baby latched-on well in football hold. observed small milk transfer (only few
audible swallows, pre/post feed weight .25 oz after 10 min. at breast) I hooked
up lactina to pump other side during feed, to help initiate better letdown &
transfer. Only extracted approx 15 cc. 10-12 min. AT the time unsure whether
poor milk output 2ndry to inadequate stimulation ( pmping 3-4x/day) or possible
severing of mammary tissue in operation. Encouraged mom to pump 6-7x/day and
put baby to breast before giving bottle/ use skin-to-skin.
Current status: per phone call mom leaking profusely; scar tissue is extremely
painful and purple in color. C/o lump in left breast at 6:00 or 7:00 position.
still pumping 4 x/day but now getting 70ml/session. Formula suppl reduced to
2-4oz per day. When feeds or pumps, feels excruciating " knife/back stabbing
pain", lasts for approx 2-5 minutes, sweats profusely, has dif. breathing. Could
it be that finally mom's milk supply came, having more let-downs, the scar
tissue has mammary glands with fluid accummualting with no way to exit? Sounds
like plugged duct on left breast. Unfortunately mom is low-income no longer
qualifies for Medi-cal & without insurance. Who should I send her to for
evaluation and referral ( surgeon?) I hope for someone who supports BF'ing- or
they may just tell her to stop BF'ing to see if reduces inflam. If Mastitis is
developing, which antibiotic is most suitable?
Public health nurse to see her today. Yesterday, I recommended, tylenol to
reduce pain, swelling, warm compresses to lump, gentle massage during
feeds/pumping. Will try to see her tomorrow. What should I do next?
Jeannette Newman-Velez, R.D. I.B.C.L.C
YWCA WIC Breastfeeding Promotion Coordinator
E-mail [log in to unmask]
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