Look up torticollis and see if baby fits the picture of that. That could
require physical therapy.

I would ask the mom what she feels capable of doing at this time. If she
wants to continue with milk expression, I would switch her to Hygeia. I
just don't like the Lactina. I don't feel it gets very good results, just
my personal experience and opinion. I would teach her reverse pressure
softening (RPS) to elicit letdown prior to pumping. I would encourage her
to elicit letdown and do small amount of hand expression to start, and then
pump for shorter periods of time, like 10 minutes but frequently if she
can, every 2 to 3 hrs. I would review easy but important pump part cleaning
and handwashing. She could do a saline rinse then apply an OTC antibiotic
ointment to her nipples after pumping. I would be trying to make it as easy
as possible for her to continue with expressing. Brainstorm with her and
see what she can handle. She can take analgesics as well.
laurie
LAURIE WHEELER RN MN IBCLC
MISSISSIPPI USA

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