Debbie wrote in a suggestion about the use of RPS for this mom and referred
her to the archives. (Without the wonderful vehicle of Lactnet, RPS might
never have come to viability.  Congratulations Kathleen, and thanks to you,
Kathy Auerbach, and all the listmothers.)

I had previously responded privately to the mother's LC, and certainly hope
we will get feedback as to effectiveness or lack of it. This is the way
that the technique can continue to be further improved. I want personal
feedback about any negative results, especially well before the skills
rotation session at the ILCA clinical day July 12.

To summarize:

In any case where edema is severe, having the mother lie on her back for as
many hours as she is comfortably able will utilize gravity as a great help
for the natural lymphatic and venous drainage of excess interstitial fluid.

This "piggy-backs" well with skin to skin and baby prone position, which
also assists the situation in several ways.

There should never be any pain with RPS. Watch the mother's body language,
and if necessary, reduce firmness of pressure and hold for a longer time.

The greater the swelling and subarolar tissue resistance, the longer that
RPS will need to be held for maximum effectiveness-occasionally up to 15-20
constant minutes.

Feedback from a NICU nurse reports that for moms pumping for babies in the
NICU (and in such situations where rapid restoration of milk transfer is
needed), repetition of the following cycle give "tons more milk":




   1. Reverse pressure softening sufficient to soften areola and trigger
   MER
   2. Short (5-10 minutes max) pumping session on  medium vacuum or less,
   depending on re-swelling effect of vacuum on areolar area.
   3. Take a break for gentle massage from back of breast forward to
   bring more milk into subareolar ducts.
   4. Repeat this cycle several times or more in a row, as often as
   desired.


Anyone desiring further info/short articles beyond what you find in the
archives, contact me privately.

Jean
**********
K. Jean Cotterman RNC, IBCLC
Dayton, OH, USA

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