I'd argue that appropriate and safe closing down of lactation, is a 
service mothers have need off.

I'm not saying you have to take that on, as you, but it is an 
appropriate health concern for the mother who has chosen to refuse the 
baby.  So if it's not in your remit, then would it be in your remit to 
make sure she does get the help from somewhere?

Hope that makes sense.  I always feel women need to be told in 
pregnancy, how to safely close down their lactation, if they refuse the 
baby.  Some don't seem to realise they will lactate - they've not ticked 
the box.  :-(

And I imagine the pump question, would depend on whether or not there is 
a plugged duct.  And I can't seen how hand expression wouldn't be better 
all round anyway.

Morgan Gallagher

Sharon Jimenez wrote:
> Wise friends and colleagues.  I need your help.  I have received a consult
> request from one of the clinics here on the reservation, but I really think
> this is outside my knowledge and scope of practice and wonder what you
> think.
> A nonlactating woman 1 month postpartum has mastitis in one breast.  One of
> the modes of treatment they have decided to use is to give her a pump.  I
> am assuming it is a hand pump.  She has no desire to breastfeed.  They want
> me to see her and make certain she is using the pump correctly.
> We do loan electric pumps and provide hand pumps, so I am familiar with
> that as part of my scope of practice.  I am not at all certain whether
> pumping is an appropriate method of treatment for mastitis since I've
> always worked with breastfeeding women.  Perhaps some or at least one of
> you will have some ideas for me.  I will go to the town where the woman is
> (about 60 miles from here) tomorrow anyhow, so I guess I could see her, but
> I feel a bit uncertain about it.  I want to tell her to nurse frequently,
> but then again, that is not her desire.
>
>   

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