Hello all:

I've been addicted to lactnet for all of 2 weeks and the time is ripe to
break my silence.  My husband and I live in Central PA with our 4 children,
ages 17 mos. - 7 yrs.  The oldest being my push into the LC profession.  I
am a private practice LC with a rental depot, LC for a home health agency,
childbirth educator, instructor for a professional lactation ed program, and
am pursuing my BSN at Penn State.  I have a tremendous affinity for
home-based care, including homebirths (my last 2 were homebirths -
wonderful!), and hope to do graduate work in midwifery after graduation.  My
latest endeavor as been organizing a _baby_ ILCA affiliate for Central PA
(yet unnamed!), which has been well-received in our bfing community - also
greatly needed!  It is a pleasure to be in the company of 700 or so persons
dedicated to moms & babes!

A mother renting from my depot called me today - she is technically in the
care of our hospital LC but had not been able to reach her.  Prior to
posting this I consulted with the hospital LC as well.  Mom has a 14 mo old
who never really bf (sketchy history here), but she did pump for 1-2 months
and obtained about 1 oz./session even with double pumping.

Now she has a 3 week old who after a vag delivery would latch but not suck.
This behavior has continued up to this day.  All else appears to be normal.
She contacted me for a pump at the hosp. LC's request at 2 days pp and has
been double pumping every 2-4 hrs. since.  Her present and concerning
situation is that she is obtaining 12-13oz/session and has begun to
experience dull breast pain between and during pumps with a sharper pain at
times while pumping.  Both the hosp LC and I feel she has oversupply and
theorize that we should apply suggestions to her that one would give if baby
were nursing.

My best info on oversupply was that presented by Anna Utter at the 1994 LC
in Private Practice conference and basically, what I suggested to her was to
stick with one side per pumping session rather than both.  Anna suggests
using one breast for 6 hours then going to the other for 6 hours, then
repeating this.  She mentions expressing for relief from the side not in
_use_, but not for obtaining volume.  I am curious if anyone else has tried
this regime.  How long should this continue?  Anna is suggesting this for a
nursing babe at the breast - does this sound ok for a mom totally pumping?
She desparately wants to continue supplying her milk to this baby.  She is
ambivalent about actual on-the-breast nursing.   I may pursue this further,
but for now she needs some practical advice.

Anna also suggests using cabbage.  Any ideas for this as well?

TIA.  Lactnet is certainly one more blessing to count at Thanksgiving this
year!!

Debbie Shinskie RN CES IBCLC