Royce:  Sounds like the classic "yeah, but" patient.  Have had many.  I 
wouldn't contact her; sounds like she has already decided what the agenda 
would be.  I'm sure it has nothing to do with you.  I tend to take my 
patient's success/failures personally but we have to remember we are there 
to consult.  There is nothing we can do if the consult isn't followed.

Carolyn Schindewolf, BS, LCCE, IBCLC
----- Original Message ----- 
From: "Royce Anderson" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, December 11, 2007 8:39 PM
Subject: client with "severe nipple pain"


> Wise ones,
>
> I recently saw a client that has a 3+ week old male and a 26 month old
> female.  She had difficulty nursing 1st babe and discontinued trying at 
> 2.5
> months. She definitely planned to nurse this baby.  She did not contact me
> prior to delivery.  Uneventful pregnancy & delivery; she had an epidural X 
> 2
> hrs and delivered vaginally over an intact perineum.
>
> Mom had decreased nursing to one time per 24 hours due to pain!  She began
> giving ABM via bottle @ day 5; amazingly baby went to breast and nursed
> eagerly transferring 32 ml from one breast.  His latch was beautiful and
> there was NO evidence of TT. We visited while babe was nursing and mom 
> never
> c/o'd of pain, winced or gave any other sign of distress.  Nipples were
> without evidence of trauma altho' she said that was b/c she had only been
> nursing one time/day. She had tried APNO but stated she was afraid to use 
> it
> due to steroid, she also stated that Soothies (hydrogel patches) did not
> work.  Every thing I offered was something tried and failed.  I strongly
> encouraged mom to change positions to decrease irritation, express MM and
> allow to air dry after nursing, use APNO and then try hydrogel patches. 
> She
> had decided against Soothies b/c they were "disposable & single use."  I
> assured her they could be reused (place on plastic card and in zip lock 
> bag
> when not in use) as long as they were not dry.
>
> I f/u'd per phone the day after the visit; she had NOT followed my
> suggestions but stated that I "encouraged" her and that she would again 
> try.
> Do you all have any suggestions? I am experienced but at a loss with this
> mom.
>
> Royce
>
> What you permit, you promote
>
> Royce Anderson
> RN, IBCLC, RLC, CD (DONA)
> The Focal Point
> 7608 Brookside Drive
> Oklahoma City, OK 73132-5641
> [log in to unmask]
>
>             ***********************************************
>
> Archives: http://community.lsoft.com/archives/LACTNET.html
> To reach list owners: [log in to unmask]
> Mail all list management commands to: [log in to unmask]
> COMMANDS:
> 1. To temporarily stop your subscription write in the body of an email: 
> set lactnet nomail
> 2. To start it again: set lactnet mail
> 3. To unsubscribe: unsubscribe lactnet
> 4. To get a comprehensive list of rules and directions: get lactnet 
> welcome
> 

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome