Hello, all. I've been hanging around for about a month now. The numbers of messages/day are certainly skyrocketing! I've been reading but never have time to "talk." INTRO: I'm an old NICU nurse clinician, old LLL Leader, and have been IBCLC since 1989. I work primarily as an LC in a hospital that does about 1200 births/year, run a Sanvita program at a large insurance company, and have a pump depot that I'm in the process of giving away (too busy, most disruptive to my home life of the things I do). I have 3 kids, all breastfed in the LLL style. I'm in Appleton, WI. PITOCIN: I, too, have noticed what seems to be a frequent association with delayed milk production and the use of pitocin. I have not seen the edema that Jan Barger referred to, but if there is an association with pitocin + epidurals, that would fit with practice at my hospital. Our induction rate is 40-45% but epidural rate is only 15%. We seem to have a ridiculous number of babies that need supplementation (not routinely, but with good indication) because of delayed milk production/seemingly little colostrum. As an example, a LLL Leader friend had her fifth child last fall with a pit induction after ruptured membranes and no labor. She had mega amounts of pit for 12+ hours to get this kid delivered, no other intervention or meds. Baby nursed well and often but was one hungry kid--Mary felt her milk had never come in so slow and none of her other babies acted like this. When it finally "came in" she had plenty, but the lack in the first few days was a real issue. MULFORD'S ASSESSMENT: We use Chris Mulford's Mother-Baby Assessment (JHL June 92 pp. 79-82) as our assessment tool and it seems to be working pretty well. Mostly it gets the nurses at least paying attention to how the baby's feeding. I'm virtually certain that some of them just chart 6's because they know that's what I'm looking for, but when it's done well it gives us objective criteria for who gets discharged with an electric pump and who gets closer follow-up. I'm blessed with an administration that supports the follow-up--there's no charge for outpatient LC visits and we have a twice a week postpartum support group where we can deal with minor difficulties and follow weights. FILLED MILK DUCTS/Denise Parker: You might try asking about a history of candida or risk factors for yeast. We have found that in some mothers yeast seems to be responsible for ducts that repeatedly plug. NIPPLE THRUSH HANDOUT AVAILABLE FROM KAY HOOVER: I just got a wonderful handout from Kay in the mail today that she has had printed to help educate health care professionals who don't treat mothers because they can't "see" anything on their nipples. It has color pictures of thrush in babies mouths, on their bottoms, and mother's nipples. It gives treatment recommendations and references. If anyone is having trouble getting moms and babies treated, this may be a real help. A single sheet is $2 including mailing, and she has lower prices for multiple copies (ex. 50-99 @ $.55 + $9 for mailing). Her address is: Kay Hoover 613 Yale Avenue Morton, PA 19070-1922 610-543-5995 I guess that's it for now; nice to meet you all! Becky Krumwiede [log in to unmask] [log in to unmask]