Hi Ann,
Thanks for sharing your interesting case!
You mention that the nipple flattens with stimulation ie. hand expression
attempts....does it do the same with the pump or does the nipple pull into
the flange?
If you are not seeing adequate extension of the nipple into the flange to
elicit milk transfer, I might try a reverse syringe. This often helps to
soften the "tougher" areola tissues and one can better control the amount of
suction and suck intervals with this in mind, creating a "milking" action.
I have often managed to express "many CCs" with this technique in instances
where hand expression and/or pumping yields little or nothing. The syringe
also provides a handy collection chamber ie. you don't lose any to the
flange, bottle neck etc. as with pumping. Obviously the now more everted
nipple may than facilitate a better latch as well.
Any questions, feel free to email me privately.
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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