I am working with a primipara, 50 years old. Perimenopausal. Of course
<gnashes teeth> she had a three day induction followed by cesarean.
She has been healthy; it's an in vitro pregnancy. (I did not order the
induction, no comment....) Full term.

Her breasts are "meaty" and the baby was having a hard time getting on
- mom "all hands" at first on top of everything else. Her edema is
mostly below her waist. Baby of course had a big first-24-hour weight
loss but the pedis are aware of the research about that. (I must say
this baby had the juiciest diaper I have EVER changed in a
newborn....yesterday) Breasts are small-ish but normal.

So overnight, mom got a nipple shield - mom is liking using it because
her nipples are sore - some poor latching despite very good help
(including laid back and nipple flipping and etc etc). Baby's oral
anatomy is fine.

Her breasts are nicely veined today.

Should I start her pumping? I don't want to add layer upon layer of
more craziness. But I want to maximize her supply.

Could not find anything anywhere about this sort of situation. Where
did I miss it? (One post by Lisa Marasco back in 2000 about advanced
maternal age)

Dawn Kersula
second guessing myself in Vermont....and off to help a redhead with
happy nipples nurse!

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