I want to publicly thank Jean for her Reverse Pressure Softening - I just
made a home visit (unfortunately, didn't get a referral until day 6) to a
lovely African American mom who was determined (as had her sisters) to
breastfeed - but the breasts became two enormous torpedoes - hard and
totally inflexible.  Nipple totally flattened so that you would think there
were none - hard as a knee!  So heavy she was using ace bandages to provide
support, as no bra she had could support them.

With RPS and a very willing baby, (skin to skin, mom on her back and baby on
top) we were able to move fluids back and breastmilk out.  How this will
have affected her breastmilk production, I won't know for a while.

HOWEVER - I want to ask questions about these situations that we are seeing
all too often:
			Why was so much fluid given to this mom that not
only her breasts, but her ankles and even her abdomen were swollen? (She
reported having been given 3 different medications to "augment" her labor.)
			Why did nurses in the hospital call this
"engorgement" (it started within hours after the birth) and tell mom just to
"use warm compresses"
			Why did MDs (both in the hospital and in the ER
where she had gone due to pain) insist that this, which was so obviously
abnormal, was "just engorgement" and tell her to just "wait a few days"
(this was day 5 postpartum) and just bind them!  Grandma, who is a nurse,
questioned the doctor - and he got so mad he walked out on her!
	
I also wonder - and please don't yell at me, just asking the question - if
we are CAUSING this horrific swelling artificially, would not using
diuretics help to remove it?  Why do these moms have to wait one to two
weeks to be able to see their ankles and feet?  If there are "protocols" to
"augment labor" - what about protocols to deal with the iatrogenic problems
they have caused?

I know, we should be convincing MDs to avoid all these interventions - but
they ARE happening - what can be DONE once the problem has happened?

Jeanette Panchula, BSW, RN, PHN, IBCLC
Vacaville, California




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