I am going to answer these questions publicly so that anyone else who
may have the same queries can have the answers as well:
- No oral assessment.
- Milk supply is not abundant, but not lacking. When I first saw
her, she hadn't nursed for three days. Prior to that - as far as I
can understand - she had only nursed the baby once or twice a day.
Again, I'm not terribly sure I have the right picture due to the
language barrier. However, she can manually express around 3oz if
she hasn't nursed for a few hours. She's just returned to her job
and is UNABLE (possibly unwilling) to pump at work. [Unfortunately,
there isn't much support for breastfeeding mothers in the workplace
here.] Even so, she's been nursing about four times each day. I
doubt her supply is a major issue because it does flow when she
expresses.
- Not sure how to answer how her breasts look (?) No prior frame of
reference. She DID say though that she experienced this same *kind*
of pain when she was pregnant. I did not ask if her breasts got bigger.
- The feed - the single feed - I was able to observe, the baby (after
a few to several tries) latched on well and nursed for a bit - about
5 to 7 minutes - and then fell asleep. BUT, the mother had just
recently given the baby a bottle of ABM. So she was already full
from that.
- Mom said the ped. was concerned about lack of weight gain and put
baby on ABM. (I only just came into the picture 12 weeks post
partum). And now the baby is approximately 75-80% ABM fed.
I'm not sure exactly what the mom wants or how much she's willing to
do to get it. I feel she wants to be nursing more. But she can't/
won't express during the day. And she doesn't understand - it seems
- a large portion of what I talk to her about. She's going back to
India within the next week and I've suggested it may be better for
her to try to get mother to mother support (within her family) when
she gets there. She said most women b/f for the 1st 6 months there
unless they don't have enough milk. (that's a direct quote). But
she's said her mom is already telling her on the phone that she
doubts that she (the daughter) is making enough milk. *sigh*.
Really want to help her but I just don't know what to do. Are there
any LLL groups in Delhi?
A milk intake scale would be super handy here.
What can we do about these nipples in the mean time? Should she be
seeing a physician?
Thanks again!
Warmly,
cian sawyer, CLC
Nassau, Bahamas
On Jun 28, 2006, at 8:02 AM, LACTNET automatic digest system wrote:
Date: Wed, 28 Jun 2006 05:02:31 -0400
From: =?UTF-8?Q?Ayelet_Kaznelson?= <[log in to unmask]>
Subject: Re- pain after nursing
Cian
There is a lot of information I would still like to know.=20
Has there been an oral assesment on the baby? Frnenulum, etc. I am
actual=
ly
surprised that with the injury to the nipple you described, she feels no
pain until after the feed. Someone should look at the nipples as well to
rule out infection at this point. I think vasospasm will have some color
changes to the nipple, even if not blanched. But this needs to be
explore=
d
further.=20
How is mother's milk supply? How do her breast look? Any change in size
while pregnant? Is she pumping (at least when baby is getting ABM)?
How were the feeds you observed? Did the baby seem to be feeding
efficiently, and did he seem satiated after? How is his weight gain?
I kn=
ow
this has been a big topic latley, but this is when I think a milk intake
scale could come in handy.
Best,
Ayelet Kaznelosn
CLC, IBCLC in CA.
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