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Thu, 13 Dec 2007 11:20:50 -0500 |
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It's not uncommon for moms to have slight differences between their
breasts that make babies prefer one or the other. Infant issues such as
torticollis (look in the archives, there's good stuff on this) can also
make the baby more effective on one breast than the other.
Some strategies that make pumping on an engorged breast more efficient:
-Reverse Pressure Softening immediately before pumping. (Jean Cotterman
had a fabulous article in Leaven on this, if you don't have it, look
online.)
-Ice compresses for a few minutes before pumping, to reduce swelling.
-Using a hospital grade rental pump. See if she can get an Ameda Lact-e
or SMB or a Medela classic; or an Ameda Elite.
(The consumer grade double electric pumps are screwdrivers. Great for
tightening screws (pumping when working, once milk production is
established). The hospital grade pumps are hammers. One can hammer in a
nail with a screwdriver, but it's bad for both the screwdriver and the
wall! That's how I explain the difference to moms. For professionals, we
talk about the smoothness of the suction curve, and the sustained
pressures the pump can generate.)
She can do RPS or ice and then pump for 10-20 minute spurts, at least
once an hour, until the engorgement goes down. Or she can put ice packs
on the breast while pumping, and pump right after RPS. Gentle massage of
the breast (dad or grandma can do this if mom is comfortable) from front
to back can help during pumping as well.
You can explain to mom that engorgement is mostly swelling, but getting
milk out helps some of that fluid get made into milk and exit the
breast. It may take one or two days of very frequent pumping to make the
breast soft enough for the baby to take. Then if baby cannot breastfeed
well on this breast, further evaluation for infant-sided problems should
happen.
Catherine Watson Genna, IBCLC NYC
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