Natalie writes;
>>In my experience,  when the engorgement is so terribly severe that use of
the
Medela Classic or Ameda SMB do not elicit more than drops of milk, the
effectively nursing baby does not get much milk either.  Test weights with
the BabyWeigh have confirmed this assessment in addition to baby telling me
the best s/he can that the breast just isn't working.  I have seen situations
where it took over 24 hours for the swelling to resolve enough to establish
good flow again despite multiple techniques and remedies.   In these cases,
temporary plans for keeping baby fed and mother going are needed.<<

Wow! This has not been my experience at all. In my 17yrs I can honestly say
that I have seen many women  who cannot pump more than drops with a *hospital
grade* pump d/t engorgement but the baby latches and milk flows well. As
described in my last post, I have also seen some that require much tenacity
to elicit milk transfer but not once have I had to suggest "temporary feeding
plans" d/t engorgement only! Not that there isn't a first time for everything
;) !, and not to confuse engorgement alone with the latchon issues that often
accompany it.
I'm also finding it hard to picture using the scale as a tool in a situation
like this. Isn't it usually very clear with an engorged breast, when the baby
*is* and *isn't* transferring milk? While the baby may not get as much with
the first or even second feed, *usually* each feed improves dramatically so
supplementing based on the first is, AT BEST, prolonging the agony.
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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