LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Mary Jozwiak IBCLC <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 4 Feb 2004 01:15:34 -0500
Content-Type:
text/plain
Parts/Attachments:
text/plain (65 lines)
I saw a mother today (permission to post) 6 days PP, with a serious case of
breast, areaolar, and whole body edema. She experienced PROM, and there was
heavy meconium. During labor The amniotic fluid was diluted by infusion of
fluid into the uterus to help prevent aspiration. (The mother says this was
painful.) She stalled at 5 cm. the baby was decelling increasingly and a
section was performed with a spinal, IV ect. Pit was also used during the
labor (sigh)

(The baby also has a terrific case of oral aversion from the vigorous
suctioning after his traumatic C birth, this aversion (or actually the
behavior, no one at hosp said "aversion") was attributed to "cup feeding
confusion" by the hospital personel!)

The woman's ankles are denting, her face is puffed, the skin on her fingers
is tight and shiney. The only recommendation she was given was "don't eat
too much salt until you clear that fluid."

Needless to say, her breast and areolar engorgement are terrible. I used
reverse pressure softening, a short pumping session, and a 16mm sheild
(baby is orally apprehesive, gags on a 24 mm. and mother has flat, almost
nonvisble nipples, he gagged during the suck assesment, with only the
*first* section of my pinkie drawn in by himself!) and lots of compression.
After rewards with the syringe while at breast (and after reinsituting the
cup feeder, as he was getting really frustrated, AND hungry) he nursed
well, appeared to realize the breast wasn't going to shove itself down his
throat and took 4 oz, (2 from each breast) and wanted more as I left! (And
after RPS and a good feed we actually saw something that might just be a
slightly protruding nipple!)He has also stopped biting her, pulling away
and shaking, and screaming when he sees the breast! (Mom says LC at
hosp "forced" the breast into his mouth by pushing on his head, and he got
so upset and shaky that he held his breath, got rigid, and started to
twinge blue.) This poor traumatized baby needed only to be treated with
respect....I think he is recovering. He nursed for comfort for the first
time, and mama, papa and grandma said they had never seen him SO relaxed
until after this successful nursing....

Anyway, *she* is still terribly edemic and miserable. We are using
cabbage,  for 10 min, after each feeding,as well as some judicious pumping
when baby doesn't drain her well, as well as making sure she is hydrated
(*her* mother, who is actually very helpful and knowlegable about BF,
seemed to be under the impression that client should not have too many
fluids.)

I know what to do for uncomplicated engorgement, Am I missing anything *I*
can do to help with the edema? (which is, of course, complicating the
breast engorgement) No one else seems to care, and she is very
uncomfortable. Cabbage on the ankles? On her face? I don't know.

Thank you all again, so much.

Mary Jozwiak IBCLC, RLC, LLLL, AAPL
Private Practice

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html

ATOM RSS1 RSS2