Good morning,
        Suggestions,please.  Have a Mom of 5 month old twins, took many
consults and nearly every trick in the book to get these kids
successfully BF but by week 6 things turned around.  Part of the problem
was small babies (37 week) and lactiferous sinuses placed WAY BACK. Ended
up using e/a flange, the other just wasn't doing it and at that time the
glass flange seemed too big.  Mom needs to pump to get 1-2 extra bottles
for supplemental feeds, daily.  Four weeks ago she had a bout of mastitis
which responded well with standard tr., but...,since then she is able to
get only half the amount of milk unless she massages the sinuses during
pumping and it also takes about 30-40 minutes to get the same amount.
The massaging seems to be an indicator that the sinuses are not being
milked adequately and I suggested she re-try the glass flange.  My
thought is that she may want to play around with the placement of the
flange and do half the pumping with it and half with the other.  In case
there are more irregularliy placed sinuses than not.  She's on
fenugreek, has live in help and seems to be doing everything eles fine.
TIA...Ann