On 24 Jul 2003 at 7:58, Nancy Holtzman wrote:
> I have a mom (home visit last Sunday) with bilateral severely inverted
> nipples. Pumping draws them out only slightly, and is painful for
> mom, but she continues to double pump 7-8 times/day because baby is
> not latching. Mom's breast tissue looks otherwise normal, when I was
> there on day 3, they were firm and she reports, heavier. I showed her
> manual expression and we were able to express drops from the right,
> and a bare glistening from the left. Using an Elite for ten minutes
> produced 20 cc of colostrum on the right, only glistening on the left.
> Now, four days later and with baby now 7 days old, mom is still only
> expressing 20-30 cc colostrum on R and nothing at all on L. She
> reported feeling a bit more fullness/heaviness in breasts, but no real
> engorgement. Lochea is decreasing, I'm not thinking retained
> placenta. No hx thyroid, no signif blood loss. Baby is doing lots of
> skin to skin and nuzzling nipples. Where is this moms milk, and could
> it have anything to do with the severely inverted nipples? There are
> obviously "exit points" (moms concern) since we can express something,
> and there was not any major, unreleaved engorgement. Just the milk is
> really slow coming in, and mom is getting discouraged that baby is
> requiring The Other Stuff. (I'm not addressing the latch issue here
> in this post, let's focus on the milk issue, we will get the kid
> latching and it will be easier once there is milk there for him).
I am from a family with severely inverted nipples. This story sounds
very much like the story of my sister who gave birth to a little girl
June, 21st.
She also had trouble pumping enough to the point that at age 1 week
she gave a few bottles of ready made formula.
For my sister letdown was extremely painful and she described that it
felt like her milk ducts were growing in a way.
I'll translate a quotation from a depressed e-mail on 29 June (day
8): "It is going up and down. Now we are going down. Yesterday we
pumpt over 30 minutes for just 10 ml. Still progress in comparison to
0 of course... And it hurts so much!"
At this time she had difficulty pumping 5 times a day.
Now yesterday I got an e-mail from her, reporting that the family
(she also has a 5 year old son) went to the beach that day, which was
possible because she was now almost fully breastfeeding the daughter.
What she feels helped was:
- support (from her husband who participated in handpumping and me
via email [she lives 800 km from us])
- a coticosteroid cream that the doctor prescribed to heal the
severely damaged nipples. This damage is not from bad latch, but from
the nipples inverting and coming out. I remember this, it feels
terrible. She used this on the night that her husband bottlefed the
baby and she didn't pump.
- her nipples were flattened by her bra and the plastic nipple
protectors (Medela) kept them humid. So she cut holes in an old bra
and she wore those day and night. Worked better than the plastic
nipple shapers. It made sure the nipples didn't go back in that much
and the wounds healed quicker, she thinks because they were open to
the air.
- She put cream (Lansinoh or something alike) on the disposable
breast pads, so they wouldn't stick to the nipples as much.
- When she didn't feel like wearing a bra at night, she put bandaid
over the hurt nipples, seeing them as wounds. She took a large piece
of plaster (the kind that you buy by the yard) and cut off most of
the sticky bit. It helped a lot and the cream stayed on, too.
- warm comresses helped (small microwavable heating pads or a diaper
or maternity pad soaked with hot water).
- massaging the breast helped, she used a bodylotion to prevent
damage to the skin.
--
Heleen Hayes
http://www.xs4all.nl/~hhayes
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