I am working with a healthy, 1st time 32 year old Mom who is of Indonesian 
background. She gave birth to a very healthy, full term 7lb 14 oz baby girl who 
has no observable sucking difficulty. Mom has one slightly inverted nipple and 
tried to feed the baby using a nipple shield on that breast and put the baby 
to the other breast. She had such sore nipples with bleeding to the non 
inverted nipple that she could not tolerate putting the baby to the breast at all. 
Baby is being fed Horizon formula and doing well. Mom  began pumping every 3-4 
hours with a medela pump-in-style advanced. I switched her to a classic pump 
when I saw her at day 3. She could only tolerate at minimum power. It has been 
5 days total now and she has only been able to get drops of milk. Her breasts 
are very engorged and painful . She is using alternate heat and massage before 
and during pumping and cold after pumping. she is also experiencing some 
flu-like symptoms , I am supposing beginning mastitis. She is on  homeopathy which 
has helped her with this so far. She says she is getting what sounds like 
blebs on one of her nipples. Any advice to helping her to pump out her milk? She 
is taking Motrin to decrease swelling and now is on tylenol with codein for 
pain. Any advice would be so wecome. thanks Jennifer RN LE 

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