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Subject:
From:
Nancy Holtzman <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 24 Jul 2003 07:58:40 -0400
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Hi all,
I have a mom (home visit last Sunday) with bilateral severely inverted
nipples.  Pumping draws them out only slightly, and is painful for mom, but
she continues to double pump 7-8 times/day because baby is not
latching.   Mom's breast tissue looks otherwise normal, when I was there on
day 3, they were firm and she reports, heavier.  I showed her manual
expression and we were able to express drops from the right, and a bare
glistening from the left. Using an Elite for ten minutes produced 20 cc of
colostrum on the right, only glistening on the left.  Now, four days later
and with baby now 7 days old, mom is still only expressing 20-30 cc
colostrum on R and nothing at all on L.  She reported feeling a bit more
fullness/heaviness in breasts, but no real engorgement.  Lochea is
decreasing, I'm not thinking retained placenta.  No hx thyroid, no signif
blood loss.  Baby is doing lots of skin to skin and nuzzling nipples.
Where is this moms milk, and could it have anything to do with the severely
inverted nipples?  There are obviously "exit points" (moms concern) since
we can express something, and there was not any major, unreleaved
engorgement.  Just the milk is really slow coming in, and mom is getting
discouraged that baby is requiring The Other Stuff.   (I'm not addressing
the latch issue here in this post, let's focus on the milk issue, we will
get the kid latching and it will be easier once there is milk there for him).
Thoughts?
Nancy



Nancy Holtzman RN BSN IBCLC
Director of Postpartum Programs
Isis Maternity
Two Brookline Place
Brookline MA 02445
617.264.4747
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