For starters, this mother should put in an Adverse Events report to the regulatory authority, which in the US is the FDA. Perhaps you can help her do this. While this may be an ideosyncratic situation, i.e. just this one mother, it is important that these situations be reported as so many aren't reported. It is only when a lot of similar reports are received, and a pattern becomes apparent, that the FDA can follow up whether there is a generic problem with a product. No reports, no pattern identified.  For more information about Adverse Events (from the ones reported), see Lawrence & Lawrence, Breastfeeding: A guide for the medical profession, Elsevier, 7th edition (2011), pp. 707-709. The authors reproduce tables from Brown et al (2005) and from an FDA database.

Sensitivities: Is this mother sensitive to the plastics used in the flanges of this machine? Is she using chemicals to sterilise the parts, a different product than previously. I wonder about the oil she is using, and if she only uses this in relation to pumping?

Contamination: Are the "sores' abrasions or do they look like an infection, e.g. impetigo?  Is she using the same old pump?  Does the problem persist with a new pump?

Finally, have you thought of teaching her how to hand-express efficiently, using the Marmet Technique? While she is learning how to maximise this, her baby can help keep the supply up at night and on weekends with direct breastfeeding. Every mother who will be separated from her baby needs to know how to hand-express, if only for emergencies.

Don't forget to have her write an Adverse evetns report.

Virginia
in Brisbane, Queensland, Australia
------------------------------

Connie Gleckler wrote:
Mom is back to work and pumping,  baby is 10 weeks old.  She has developed sores on the sides of her nipples.  She has tried 27, 30 and 36 flanges.  When she bf during the weekend they heal, soon as she starts pumping they open up again.  She is putting oil on inside of flange and has lowered the settings.  She pumped exclusively with her older child for the first 6 mo. with the size 27 flanges with no issues.  Any Advice?

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