Hi,

I am currently working with a mother whom I have known and worked with over 
3 or her 4 children - but she hasn't been able to successfully breastfeed 
yet, and I am not sure this is going any better, so I am appealing to you 
all for any suggestions.
To go into the other 3 lactation histories would take a book.  But......she 
has inverted nipples (coming out more and more with each baby)  The right 
nipple was quite everted today - but looks like a little cauliflower.
Anyway, this baby was born Dec 23rd, vaginal breech birth (undiagnosed 
breech) 10 days overdue.3600g  So she is now day 4.  Baby is attaching at 
the breast with a nippleshield, but thrashing about and not closing his 
mouth around the nipple without the shield. (we used a hand pump to get the 
nipple to come out a bit)  Mothers breasts are very firm.  In previous 
lactations she had really, really severe engorgement, but this isn't too 
bad.  Mother can't hand express milk, and none comes out with the pump. 
There is little milk in the shield (a few smears more so than drops)  I felt 
that she maybe wasn't letting down so well.  But today we talked and chatted 
about our kids/chirstmas - we know each other quite well now.  When baby was 
on the left breast the right began to dribble a bit, which was great, but no 
leakage from the right when baby is on the left.
Baby is being fed formula 30-50 mls at a time via a supply line (every 2-3 
hrs), which he is taking quite well.  Lots of skin to skin contact.  But we 
can't get that milk out of the breast and into the baby.  With her first 
baby, mother had very severe engorgement, and although baby seemed to feed 
well, quickly became lethargic, jaundiced and lost more than 10% of 
birthweight.  Similar pattern with 2nd and 3rd.  Mother is strongly 
motivated to breastfeed.  Any suggestions would be gratefully recieved.
Barb
IBCLC Australia

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