Hello,
I would not dare saying you are conservative or not :-)
But what I can say is:
YES to relieve congestive experience, if breast are too full the mom is at
risk ++ of developping mastitis maybe worse.
NO to reduce the mom's milk production; it is far too early;
when one uses drugs (from pseudoephedrine or birth pill) or herbal teas
(sage), one never does before 6 weeks postpartum;
before, one should try manage the engorgment in order to avoid developping
mastitis (inflammatory - infectious...);
this is while nursing/pumping, the more she can, PLUS massages, that she can
be relieved from engorgement/mastitis;
Concerning milk production: the mom of premature baby NEEDS to be at 150% of
the production of a healthy term-bornt baby; including for mom of twins who
will need to get it TWO TIMES this makes around 2 liters per day in fact
when I calculate being 150% of "term-bornt twins, 1 liter per breast or
something like that);
So I may dare telling you: do not reduce her milk production; because one
knows milk production of moms pumping goes down at the end of the first
month, and it is hard to get out of it;
The importance is: never stay until breasts are too full, because this leads
to breast pathologies;
and for pumping mothers, more for pumping mothers of premature babies, be in
super-production from the beginning or from early beginning; and keep on
being in super-production; then she will reduce the pumping whilst
breastnursing is upper and upper.
Well I would have wanted to answer earlier and take more time to answer your
mail, but I was in Paris .... had no connexion, got back home and need to
prepare my luggages again I am leaving again; but I will have internet
connexion !
Breast regards,
Françoise Coudray
Lactation Consultant IBCLC
President of ADJ+ Breastfeeding Twins and +
(Allaitement Des Jumeaux et Plus)
http://www.allaitement-jumeaux.com/
http://www.allaitement-jumeaux.com/expo2001/
----- Original Message -----
From: "Cassandra Leahy" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, December 11, 2008 5:49 PM
Subject: Hyperlaction Twins in NICU
I could really use some good suggestions for the following situation (I
do have permission from mother to post):
Mother with premature twins in NICU
Exclusively pumping (plan to initiate feeding directly at breast asap)
When contacted me she had been pumping approximately 8-10x/24
hours, obtaining approximately 10 oz/30 minute pump session
Taking second round of antibiotics for Mastitis
Reporting continued "lumpy-hard spots in breasts" bilaterally with
discomfort
Currently we are working on "Reduction of milk synthesis" by increasing
length of time between pumping session and decreased pumping
duration, along with ice packs/cabbage leaves for comfort, Motrin as
needed, and gentle light tissue massage in areas that require
attention. Mom will pump to relieve pressure when needed.
We are being ultra conservative due to the fact that she has twins and
they are not feeding at the breast yet.
We have had little reduction in supply or comfort in 1 weeks time; mom
still c/o same symptoms.
Am I being too conservative? Should we be more active in the reduction
of milk synthesis; if so what would pumping recommendation be at this
time? I usually do not recommend supplements or medications unless
needed---do we need to introduce?
Other than peppermint tea or sage, are there any other
herbs/supplements that you have found to be effective? I am also
interested in learning if anyone has every recommended Sudafed and
the results you experienced.
Usually I can help mom manage with one breast feedings/block
feedings/and positioning techniques, but in this situation, I am hesitant
due to NICU issues and exclusive pumping.
Mom is looking for new suggestions and I would appreciate any help you
can offer us.
If you would like to email me privately, my email address is
[log in to unmask]
Thanking you in advance,
Casi Leahy
BA, RN, MSN, LCCE, IBCLC
[log in to unmask]
www.thelactationlady.com
Fax: 888.225.2855
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