Dear all:

I wish I knew how to send a picture to Lactnet.  I can't tell you how confusing I found 
Reverse Pressure Softening until I saw a diagram.

Anyway --- here's my attempt at the tube thing (which also caused confusion several 
years ago when I tried to describe it).

The layers are breast, tube, tongue.  

If baby is attatching in cross cradle, that would be on the inner aspect of the breast, 
parallel to the ground.  If baby is latching from the side (football) then it would be on the 
outer aspect of the breast parallel to the ground.  If baby is at an angle (cradle) or at the 
side (slanted football) then the tube would be angled accordingtly.  If the baby were 
straddling the thigh sitting up, the tube would be coming up from under the breast to the 
nipple.  

I agree with Laurie Wheeler about the Lactaid --- I really like it for long term situations.  
But I didn't mention it in this particular case because attachment was so challenging that 
the thought of placing the tube on the Lactaid seemed like it might make difficult 
attachment even harder.  I actually loved the Jack Newman bottle system.  I recently 
tried it with two women in support group (can you imagine?  I had three women show up 
on the same day using various different tubes on the breast along with 12 other 
women?).   Just like figuring out where to tape a tube, I really couldn't visualize this little 
bottle system until I saw one.  Basically, it was a bottle with a hole punched through the 
cap and a #5 French feeding tube with one end at the bottom of the bottle and the other 
end at taped to the breast.  I assume the cap is merely to prevent spillage ---- which is 
so much better than trying to  rig up a 30 ml syringe with a rubber band and a safety pin 
and hoping not to spill it.  I used to use the syringe and feeding tube as a cheap throw 
away until mom decided whether or not she could really use a tube on the breast rather 
than spending a lot on a Lactaid or SNS only to use it once or twice and decide it was too 
much work.  In this particular case, I think the flow from a larger #5 French feeding tube 
might be faster than the SNS and, therefore, might not optimize stimulation.  

Ditto on the rolling the nipple shield on.  Its very important.  I think of it like putting on a 
stocking.  You can't just put it on straight from the top, you have to roll it all the way 
down to the foot part and then pull it on.

Best, Susan

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