The two things that concerned me a little in talking to the mother was the
weight of the baby at the one week check up at peds.  She said that doctor
was happy with it.  The other concern was that she supplemented with
bottles on Wed and Thur and pumped every 4-5 hours and maybe more.
When I made suggestions to the mother of two week old baby for what she
can do for her oversupply I stated taht she can use warm and cold
compresses between feedings.  Take a warm bath or shower.  Let the water
run over breasts.  "You can use ice too between feedings."  Do breast
massages with the palm of your hand.  Do breast massages while nursing the
baby.  I also suggested to her that she pump after the feedings and can
express some milk from her breasts before a feeding.  I made no comment
about cabbage leaves because she stated a couple of times that she didn't
think that she was engorged only "almost".  I told her that when pumping
is needed like when you are away from your baby, your supplementing or
working La Leche League suggests that mothers pump about every 3 hours.  I
thought it was important to tell her that since she went a long time in
pumping on Wed and Thur, 4-5 hours.  She asked me, "Well how long would I
pump for?"  I said, "until the breasts are empty.  You want to keep your
supply up."  Supply and demand.  Another suggestion I made becasue I
wasn't sure if she was bfing enough was to watch the feeding cues and that
when she saw her baby's eyes flicker and body movements while asleep she
should wake her up.  "You won't be disturbing the baby's sleep because
these sleeping cues are a sign that baby is in a light sleep and not a
deep sleep.  It's a good time to wake baby up.  Baby will be waking
soon."  I tried not to overwelm this woman with too much because she
stated taht with her first child she pumped all the time and it was tiring
and exhausting.  She wanted to breastfeed this baby and didn't want to do
the pumping around the clock thing again.  I also tried to be suggestive
and guiding so not to scare her at all.  I never said well I'm concerned
about xyz or well you should....
Mother claimed that her breasts were not hard.  She was not in pain at all
and there was no fever.  Baby was feeding well, she said.  Breasts were
just sensitive to touch.  Based on this information that she gave I didn't
think she was engorged.  I have a feeling I will see her on Tuesday
morning at the La Leche meeting because she stated a couple of times that
she was going to go and that she looked forward to going and seeing me
there.   I get the feeling that this mother is very dedicated to
breastfeeding and will do what is necassary.  You know when you know from
just talking to one without seeing them?  Should I encourage her to see an
LC and have her baby weighed again when possible?

Thank you to all.  Any other advise?
Claudine

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