How long will the team be waiting for tongue revision?  It's not always about a tongue-tie -- and a revision is not always a miracle "fix."  Building milk production with a pump can be very challenging.  In the nicely presented story, you highlighted the 5 hour pushing stage, which certainly seems like a possible factor -- many babies would be getting back into  alignment after a rough road like that.  If you have a bodywork practioner/physical therapist that you trust, that may be another avenue to explore. Her body also had a shock -- a very long pushing stage is associated with delays in Lactogenesis II.

 On the Platinum, the speed and suction are controlled separately -- has she experimented with starting with the action fast and light, then switching to slower and stronger, and toggling back to fast and light when the flow slows.  Many mothers need lots of tips and tricks on pumping -- warm compresses, lots of lubricated massage and hand-expression before and during,http://bfmedneo.com/ relaxation and distraction (funny videos, guided imagery relaxation audios on YouTube), hands-free so she can eat and drink and play with the baby while pumping -- not staring at the milk..  If the breast seems tight, perhaps some reverse pressure softening right before pumping, to see if it loosens up the "traffic jam" of body fluids in the areola and allows better flow on the ductal roadways.  Nature never thought about us pumping -- mothers have very individual reactions to this alien piece of equipment -- so encourage her to play around.  Has she tried a Symphony instead?  Continue experimenting with the flange size -- sometimes a flange that is "too big" seems to move the right amount of tissue for flow.  

If there was more milk a couple days ago, reassure her that that milk making tissue is still there -- "the workers are in the factory -- but the production has been disrupted."

The baby is changing every day -- after a few days off the breast, he may be a different dance partner --  would she be up for doing short practice sessions with the baby?  This baby is being nursed by the mother's sisters!!  How does the baby feel to them?  If the baby can nurse with his aunts (and maybe that says whether the tongue is the issue or not), why not at least some practice sessions with the mother, or for "dessert" after the bottles -- letting the baby organize and seek the breast, and then help the baby out with a big exaggerated Rebecca Glover latch to fill the mouth.  Getting this baby back on the breast could be huge turning point.  If she can maintain the pumping as the baby gains the skills, she creates temporary "twins" to put crazy demand on the production.

Anyway, a few ideas.

Margaret Wills, IBCLC Maryland

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

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