Jennifer writes:

<Cesarean birth is inhernetly a risk for structural damage and
the reasons (real or created) for the cesarean can also be a cause of
structural trauma. In such a case, I would do two things--assess baby's
ability to feed (as opposed to mom's breasts being the problem) and
refer if needed and I would suggest the mom take milk thistle and
dandelion leaf to rapidly alleviate the edema.>

Judy writes:
< A few handfuls of parsley, cold compresses, RPS, etc as
mentioned  >

3 things in the above posts stand out for me:


   1. Woolridge describes effective suckling as an interactive process in
   which the mothers breast tissue adjusts to the geometry of the baby's oral
   cavity. So both sets of factors need to be assessed. The areola must be
   reasonably pliable to respond to baby's efforts, especially if birth trauma
   or drugs, immaturity, or problems with neurologic function or oral anatomy
   compromise baby's efforts. Excess subareolar tissue resistance skews ability
   of the maternal tissue to reciprocate effectively to the latching efforts of
   even the most robust infant.


     2.  I don't think it's a matter of saying "the mom's breasts are the
          problem" as much as it is saying that birth interventions
sufficient to
          cause overhydration in the first place, perhaps with extra pitocin

          adding an antidiuretic factor, often exacerbated by injudicious
          pumping, brings on "distortion and overdistension" of the tissues
of
          the breast, especially, the tissues of the nipple-areolar
complex..
          This is in no way "blaming" the mother's breasts but rather
          recognizing that they have been subjected to iatrogenic stresses
          which compromise their normal function.

("The physiologic unit of the nipple-areolar complex appears to function as
a closely connected system. Forces acting on any one part of the NAC may
cause other parts to compensate." JHL RPS article).
Overfilling of subareolar ducts often tugs inward on the galactophores in
the nipple, masquerading as flatness or frank inversion, while edema of the
connective tissue may temporarily increase the nipple circumference, elevate
the areola and thereby appear to decrease the height of the nipple.


3) Overhydration with crystalloid IV fluids causes dilution of the normal
protein content of the blood stream. It is this physiologic imbalance which
allows too much fluid to leave the arterial capillaries too rapidly, and
prevents the prompt re-entry of the excess fluid into the venous (and
lymphatic) capillaries. Since diuretic action takes place in the blood
vessels of the kidney, significant diuretic action is unlikely to take place
until the excess interstitial fluid first re-enters the blood stream to be
delivered to the kidneys. Gravity and positive pressure are two factors that
can also assist re-entry of excess fluid into the circulation.


Please contact me privately if you are interested in receiving my short
article on Pitting Edema and the use of RPS, or my illustrated instruction
sheet.

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

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

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