PTP

I am working with an exclusively pumping mom. She is not directly breastfeeding due to pain and nipple-compression. Baby is 10 weeks old. The baby has possible structural issues due to transverse lie resulting in a planned C/S and tight lingual and labial frenulae but parents do not want to do body-work or frenotomy.

It seemed that it was possible to have comfortable feeding with a nipple-shield but Mom later said it hurt too much to directly breastfeed even with a shield.

She does not feel able to pump more than 4-6 times a day due to pain when pumping. She gets between 10 and 14oz daily. Immediately PP, she reported dizziness and chest pain when pumping. After improving her diet, she reports no dizziness but has continued pain which limits her ability to pump.

She describes the pain as following:

<Now, I do not feel light-headed as before. But I still feel pain in my
chest, upper back, spine, neck and shoulders. The pain is in the upper
body. I am taking Advil (2x 800mg, a day). It relieves pain only for a
while and comes back as I keep pumping. I am eating better now and also
taking a Multivitamin (Postnatal) daily.

I'm using 30mm sized flanges. I guess they fit me well. My nipples do not
rub against the walls of the flanges and my areola is also not drawn into
the flanges. Only my nipples are completely drawn into the flanges.
However, I think I might be turning the suction high. I would want to try
lowering the suction and see how the pain would feel.>

I have encouraged her to massage before and during pumping to help with let-down, but it only seems to increase her pain. Does this sound like mammary constriction syndrome? Would simple doorway stretches help or would she be better off with body-work herself?

Laura

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