In a message dated 5/22/2004 9:00:18 AM Eastern Daylight Time,
[log in to unmask] writes:
Re: "Deceptive Nipples"-Sore Nipples from Pumping
The wrong shield size wreaks havoc for the
working mother.  I have bumped into many a mom just one month post return to
work who has practically brought her milk supply down to non-existence.  It is
not uncommon for a mother to need two different sizes for the left and right
nipple either.

Thanks Debbie, your insight is very helpful.
What percentage of women that you "see", do you find need a size other than
standard?
Having recently disbanded my rental station of 10yrs, I have to admit that I
had less than 5  Moms that "needed"something different. I emphasize needed
because many more may have benefited by a change, but it wasn't until recent
years that this became an option and frankly Medela never provided education in
detection/prevention. With the large population of NICU moms in my hospital
receiving pumps on any given day, it makes me wonder how much of a role flange fit
plays in problem production etc, over time.

you also write;
Recently, I came across an Indian woman with Day 4
engorgement from her second child.  Over the phone, she states, "I pump and
pump,
but I still feel like I have milk when I am done".  Without larger shields,
this mother would have certainly developed mastitis

I'm confused here.....are you suggesting that "without complete or optimal
breast emptying "that this Mom would have developed mastitis? Please clarify.
Thank-you!
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts
I'm confused

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