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Subject:
From:
Lynn Shea <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 5 Feb 2003 14:52:50 EST
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In a message dated 2.5.03 1:30:34 PM, Diana writes:


> The goal was to remove
> the milk as effectively as possible -- and hopefully to move the milk in
> the stagnated ducts -- without encouraging further production.  One of my
> first recommendations was that she reduce the amount of time she was
> pumping, but that she use a better pump.  I felt it was critical to use as
> effective a device as possible to remove the milk.  A piston pump is more
> effective than a diaphragm pump.
> The Pump-in-Style may have been
yielding a good quantity of milk, but was it actually draining as many
ducts as possible?<<

I think what you are saying here is that given the same amount of milk 
removed,   the medela classic would be more likely to empty a larger number 
of ducts then the PIS. An interesting hypothesis and not one that i would 
have envisioned. Is there something about pumping physiology that makes you 
think this?
You also seem to be suggesting that the classic would remove the milk more 
quickly thus diminishing breast stimulation and finally, overproduction. I 
would be interested to hear from others on this, particularly in light of 
discussions over the last year or so regarding the idea that it is milk 
removal that drives milk production NOT breast stimulation. Just out of 
curiosity, did it in fact require less time to remove the *same amount of 
milk* with the classic?

you also write;
>>She did her best to get help: she called a volunteer support
organization and an IBCLC from the hospital and requested consults.  Both
individuals were only able to see her in isolated visits, which did not
allow them to understand the complexity of her problem.  Knowing she still
needed more help, she sought out a private practice IBCLC.  Because I was
able to spend a significant amount of time with her, I was able to peel
back the layers of her case to soft out the true problems and
causes.<<
KNOWING that overproduction can lead to stagnant milk and clogged ducts and 
SEEING the changes in the breast contour as you so eloquently described 
SHOULD have led both of the above practitioners,particularly the LC, to the 
same conclusion that you came to.

Sorry if I seem hung up on your suggestion to change from the PIS to the 
classic :).   Its just that over the last year or so I have seen clients 
looking for gadget after gadget recommended by an LC over the phone. I saw a 
mother of 1 wk old twins last night who called initially for a SNS, 
recommended by an LC over the phone for latch problems with one of the twins. 
Now,although I know many of you do, despite many years of trying I have never 
been able to use an SNS to facilitate latch. The baby needs to be able to 
latch to latchon to the breast and the SNS just as well as to the breast 
alone. 
The switch to the classic from the already purchased PIS was expensive for 
this Mom and I hate to hear the feedback (and I often do!) that certain LCs 
are gadget (sale!) happy. It reflects negatively on all of our practice!   A 
bigger issue than what you are talking about, I know, but one worth 
exploring!
Thanks for sharing@!
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts



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