On August 22, I posted about a mom I was working with who was struggling
with great sensitivity to oversupply, plus nipple pain. We were already
trying 4 hour per side feedings but things were not improving-- mom
needed to pump in order to relieve the pain. After conferring with Diane
Wiessinger, we revised the plan to having mom start off with pumping
both sides all the way down, and then nursing baby on one side for 6
hours. At the end of that 6 hours she was to pump the nursed side the
rest of the way down and switch baby to the other side, and so on.

I just spoke with the mother today and she is very happy. She says that
she kept strictly to the plan for the first 4 days and was initially
pumping off about 10-12oz of milk in 24 hours. Now, 12 days later, the
pain of the fullness has decreased and she has relaxed the "schedule"
per side a bit and is only pumping twice a day for a total of 5-7
ounces. She is much more comfortable, and baby is settling down.

This mom was also dealing with nipple soreness that was exacerbated by
the engorgement. When I introduced a nipple shield (both for pain and
for helping baby cope with the milk ejection reflex), mom found great
relief, but baby did not transfer milk well. We decided on a
combination, starting with the nipple shield until the edge was taken
off of baby's hunger, then switching to bare breast so that he could
tank up the rest of the way. After one week of this, mom's nipple pain
had improved enough that she was able to discontinue the nipple shield
all together.

The most important part is that mom now feels in control. She is about
95% there and knows how to accomplish the last 5%.

~Lisa Marasco

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