dear chris,

i am curious about your local lc who seems interesting in promoting a
mechanical "answer" for every mother. does she sell these things to her
clients herself? does she make a profit selling these things?

 one of the reasons i don't do pump rentals (besides the fact that we have
extremely excellent businesses here that do that and i couldn't possibly
compete, even if i wanted to - hi sue!) is that i don't want to find myself
trying to make money with gadgets. in fact, i charge a lot for visits and then
i try to include things for free that cost five dollars or so. so, if i think
a person really needs a nipple shield, i just give them the one that fits the
best. *i* pay for it as overhead. believe me, it certainly helps keep me on
the straight and narrow about not pushing "stuff."

and speaking of stuff, helen knows we have agreed to disagree about the nipple
everting item (hey, we agree on the important issues - chocolate). since i
don't carry around a pump, and try to recommend getting one only if a mother
really, really needs it, if i want to see some milk from a mom i try two
things: teach hand expression (doesn't always fly). or, use the nipple thingie
to get a little milk,  (done when baby needs to get a little bit right away
and can't/won't get on).

 if a mom can express some milk, you can catch it in the soft cup. if she
can't or won't, you can express a bit with the everting thing and either way,
feed it directly to the baby from the cup on the end. something about getting
a pump and pumping a larger amount of milk seems to cause bottles to appear
like magic to put that milk in.  it is so easy for a mom to get caught up in
the pumping and bottling thing.

and then, too, if there is only the tiniest bit of colostrum or milk, it
doesn't "get lost" in the pump stuff, and you can also feed it to the baby.
(more than once a client in the hospital has had a nurse throw away the
colostrum or tell her to "just rub it on your nipples, there isn't enough to
feed the baby".)

carol brussel IBCLC

ps also, even though there was once a long thread on lactnet about using
homemade nipple everting devices, some wise woman amongst us says "nah-uh,
don't do that, liability issues there"