Chris et al,

If the mom calls me on the telephone with this sort of problem (I live hours
away from my work and can't just run out and see her) I suggest the old "juice
Jar method".  It has been a life-savior (and nipple rescuer).

Fill an empty glass Cranberry - juice sized jar (about 1 liter and 5 cm opening)
with very hot water.
The glass will become very hot and now needs to be held with a towel.
She then uses a cool washcloth to cool down the rim and upper part of the jar so
that it can touch her without burning (I have her test it with her inner arm).
She then puts it to her breast and holds it (some moms lean over a table to do
this, others just hold it in their laps on a pillow and lean forward).
As the air cools inside the jar, it draws the breast in with a vaccuum and milk
begins to come out.   Some moms need to repeat this, others find it works with
only one try - one mom called to ask if she could freeze the milk she drew out
because it was so much - and the baby nursed very well afterwards!

In the clinic, I use the baby, allowing him to latch on - not perfectly - but
sucking a little, then take him off, then back on, then off - if the mom's
nipple is not very sore, this works OK and after a few tries the baby has enough
good graspable breast in the mouth so the breast can be milked correctly.

See some of you later!

Jeanette Panchula
Puerto Rico
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