Perhaps she'd respond better to hand expression (maybe the Marmet technique?).  Is her baby latching better now?
    
  WRT the uric acid crystals in the baby's diaper--it's my understanding  that those are microscopic.  Was this confirmed by testing or did  she visualize something in the baby's diaper?  Disposable diapers  often have a powder in them that gels when wet, and sometimes they  leave a residue on the baby's bottom.  Forgive me if I'm way  off-base here--I've seen the diaper residue myself this week and that  was the first thought that came to mind when you said crystals in the  diaper :)
  Jen

Date:    Tue, 15 Nov 2005 17:49:46 -0500
From:    Debra Ray 
Subject: need suggestions

Please forgive a post that is a bit lengthy. I am a recently certified
IBCLC, although I have worked with nursing dyads or many years as an OB RN.
 I have a client that has me baffled and I'm asking for suggestions.

She is 28 G1,P1, baby is 5 days old, term baby, 9+#
vag delivery, forcep assist after 2 day induction

baby did not latch well on day 1, but did better on day 2, especially with a
shield (mom has OK nipples, but they were very puffy after 2 days of IV
fluid and many hours of epidural, she went home on day 3

on day 4, she called me to report uric acid crystals in the diaper and baby
not nursing but every 4-5 hours

early AM on day 5,(yesterday) she started supplementing, and baby was down
13% from birth weightat the pediatrician, who sent her back to me

Her breasts feel full, but she was unable to pump more than a few drops,
even after I switched her to our hospital grade pump.

I sent her home with a SNS (after I watched baby nurse at the breast, with
nipple shield and SNS)and instructed her to pump after each nursing.

Today, she reported by phone that she has been able to pump only about "a
1/4 inch in the bottom of each bottle" (she rented a hospital grade pump)
and her breasts still feel "hard as a rock" pumping.

Her nipples are sore with some scabs, which we removed with warm wet soaks
and lanolin prior to pumping, massaged the breasts, and I asked her again
about previous breast surgery (none).

I'm baffled as to why we can't seem to empty her breasts. Any ideas?




		
---------------------------------
 Yahoo! FareChase - Search multiple travel sites in one click.  

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html