Karen,

Re your post about mom of twins with low milk supply and possible nipple 
blebs, some thoughts.   Has she tried more intense treatment of blebs/plugged 
ducts?  The thought occurred to me that there has been little direct contact of 
nipple to mouth or any "lubrication" of nipple.  (you mentioned nipple shield 
use when babies breastfeed about 4x/day; I understand rationale.).  I wonder if 
using BF Atlas suggestion of cotton ball soaked with olive oil worn over 
nipple in between feeds/pumping, castor oil massaged into ropey areas of breast (s) 
with heat application several times per day, and some direct nursing without 
shield could be tried?  Soaking breast in a cup or bowl of warm water or 
chamomile tea (chamomile has anti inflammatory properties) with gentle massage has 
helped moms I've worked with when ducts plugged/nipple blebs.  

You also mentioned this mom not being able to go on domperidone; how about 
herbal galactagogues?  In this regard, a mom I'm working with re supply issues 
tried rasberry leaf tincture on her own for letdown with good results and when 
I posted on the herbal bf site recently someone suggested fennel for letdown.

Mom is lucky to have someone like you to give her support and work overtime 
to help her.

Barbara Latterner, BSN, RN, IBCLC





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