Robin, I figured you had done all that and I was interested in the info and
in the care plan too.  I still don't think the compress had a lot to do with
the milk supply - as you note, the baby hadn't been feeding well before and
luckily they came back to someone who knew enough about breastfeeding to fix
that, and ensure that the baby got fed while things were being worked on in
all the other ways.  Of course the quality of the mother's postpartum time
was being adversely affected by the feeling of never being clean because of
an ill-smelling foreign body that shouldn't have been there, so it's good it
got dealt with.  It also points up the importance of following women up
through the first few weeks post partum.  Our standards in Norway for that
are under scrutiny.  Current requirements are that the public health nurse
make contact (phone or visit) within *two weeks* of hospital discharge and
we all know that is not soon enough to deal with a lot of start difficulties
with breastfeeding.  I feel really fortunate that we are able to offer women
follow up in clinic within a couple of days, and we don't have a limit on
the number of times they may use the clinic in the interim between going
home, and starting community care.  Most places here don't have a foolproof
setup for that vulnerable period and boy do we notice it in the nature of
contacts with the breastfeeding mothers' organization.  Babies like the one
in this case are exactly the kind that should not be left floundering for a
couple of weeks.

IMO there is always room in a Lactnet post for at least a summary of the
whole assessment and whatever plan of action you've landed on.  Saves me
asking for it afterwards, anyway :-)

I forgot to mention that at least one of the women who had a forgotten
compress in our clinic had already been back to us for a routine check after
early discharge, and none of us noticed anything out of the ordinary then,
on day four.  By day seven, though, it was impossible to ignore.  Definitely
the kind of thing that can happen to anyone, as long as compresses are used
instead of tampons.  I hesitate to say so, but we don't even count
compresses in our birthing rooms during and after suturing, we don't keep
track of how many packets we've opened, or how many we've used up.  They
sure do in the operating room.  But it is expected that we use the tampons
provided in the sterile birth packs for that purpose.  They aren't exactly
the kind you could just slip into a pocket of your skin-tight jeans and not
get noticed!

Rachel

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