Pamela, your long post was eloquent and -- from my greatly less-experienced
perspective -- seems spot on to me.

The only place I would spin the tone a little differently is where you say:


<< Impress upon the mother the need to keep this up even though it can be
demoralizing and tedious, and the dangers of  just leaving it. >>

As one who has been severely engorged with both my kids, I'd have to say that
while pumping and hand-expression are tedious, they are VASTLY less
demoralizing than the pain and difficult latch-on that go with real, nasty,
prolonged engorgment.   With my first baby, I greeted the sight of my
wonderful doula with pump in hand on day 3 (are you reading, Ruth?) as if it
were the apparition of an angel -- What a relief!    The person who gives you
permission (or directions) for pumping is like a messenger of the good news,
in that situation.

The key thing is to get across that:
1. Relieving your discomfort is good for your bf progress, not bad or self
indulgent or against advice.

2. This is a short stage, while your breasts and your baby get adjusted to
each other -- maximum a week; you can survive it.

3. Great news!  Your breasts are full of milk for your baby, and lets keep it
that way by draining it well. And, from the long-term milk supply
perspective, its better to have too much in the first week because you
encouraged it and pumped off the extra, than to be sending your breasts the
message that the milk is unwanted or unneeded and they shouldn't make so much
of it.   TIme enough for that later, when you and your breasts and your baby
are all a little more used to each other.

All of which is not to disagree with you, Pamela, in any way -- but only to
say, take heart, because if my experience is at all typical most engorged
mothers are going to be very happy to hear this advice.

Elisheva

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