Well, good news and bad news.

The woman who'd had a breast reduction but who pumped up to 2 oz per breast
with a mini-electric with her first child, with no direct bfing after the
early days but also with chronically oozing nipples, has found the answer
the second time around.

I had to leave town last week shortly after we talked, but I left her with 2
larger sizes of flanges to try on the Medela Classic and with a Whittlestone
to try as well.

She never tried the Whittlestone.  She found that consistent use of the
extra large flange (not the large) cleared up her nipple up on that side.

The bad news: she also found that the low supply from sporadic pumping, the
pain she'd felt until now, and the burden of two children had all sapped her
energy, and she is "pumping down" to quit.

I gave her multiple alternatives, including nursing on the healed breast
just once to see how it goes, and trying again in a month or more, when the
baby's mouth is bigger (the baby is 6 weeks now).  She was pleased to hear
that she might be able to resume nursing at that point if she decides she
wants to; I think for a lot of women who are closing the door with some
reluctance, knowing that they haven't *totally* closed the door helps.

I'd be delighted to hear from her in another month, but I won't hold my
breath.  How very sad that it took 2 years and 2 babies to get to the bottom
of this.

The lesson to me:  infected-looking, crusty nipples may in fact just be
battered, even with a good pump.
--
Diane Wiessinger, MS, IBCLC, LLLL  Ithaca, NY
www.wiessinger.baka.com

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