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Date: | Wed, 21 Feb 2007 09:58:36 EST |
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LuAnn, I think what is important on management of engorgement is that not
all women produce milk equally. There are some women who are just more prone
to engorgement and not because they skipped feedings or their baby is not
getting enough.
As lactation professionals we really need to assess each case on its own
merits and not rubber stamp either the management or the cause. I know this
frustrates people from the nurses, doctors, parents and LCs but there really
isn't simple answers.
We can certainly make generalizations which should cover most cases but than
need to be opened minded and flexible when symptoms fall out of the normal
curve.
So, if a mother continues to have engorgement it needs to be addressed or
she will have a negative feedback inside her breast that could lead to decrease
supply. Moms need to be given treatments that relieve their symptoms while
taking a very through history. Having a mom pump down to soft when engorged
should not start something that cannot be controlled. Engorgement makes for
difficulty latching and hand expressing. If mom can soften a breast enough
for the baby to latch, the baby may help the mother with the rest.
There are moms who need to down regulate their supply because that is how
their bodies work not because they over used breast pumps or expressing. I
think we should be very careful not to jump on the pump as the reason to this
problem. The facts just don't support it.
Take this case by case and listen very carefully to what the mother is
saying.
Ann Perry, RN IBCLC
Boston, MA
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