Dear Lisa:
This is indeed a difficult situation, and and you're digging deep in the
toolkit! Were there any clues in the small improvement she noted?
Women have very individual reactions to a pump, and sometimes it helps
to track what exactly seemed to play into the better sessions. What
made her feel it was an impending plugged duct when it resolved with
gentle massage in the next feeding, rather than just a full area?
Other pre-pumping prep ideas -- pumping after a hot shower, leaning
forward, with the breasts hanging free and doing a jiggly "milk shake"
massage, with quick finger-tip tapping around the breast, wakes up the
nerves and mobilizes the milk forward (and this may somewhat increase
the pumped milk's fat-content by loosening the fat globules on the cell
walls). And maybe do a little preliminary nipple stimulation and
hand-expression into the flanges before positioning them on.
It's useful for her to see hand-expression that really shows squirts:
https://www.youtube.com/watch?v=Fs-WEgrLJF0&list=PLoaoJf2DnVbkxeSOkQ_pMuTtN2B6f9PnR&index=7&t=13s
https://www.youtube.com/watch?v=Fs-WEgrLJF0&list=PLoaoJf2DnVbkxeSOkQ_pMuTtN2B6f9PnR&index=7&t=13s
Hand-expression is a great skill to have, and if she just needs a few
ounces for occasional separations right now, it might help her feel like
she has a backup plan while she's figuring out the pump.
Is the return to employment and the increased need for the pump
happening soon? Is that adding to the stress?
Even if her personal-use pump, a reputable brand, is functioning
optimally, would she be able to try a short-term rental of a actual
hospital pump? (Every pump sold bills itself as "hospital grade,") Even
if the suction levels aren't different, a rental pump's bigger,
sometimes quieter motor with a smoother, steadier pull and gentler curve
on the suction release, seems to make a difference to some pumping
mothers. And a different machine doesn't have that association with
frustration.
Good luck to all. Let us know when there's the breakthrough -- it's
always informative to hear the end of the story!
Margaret Wills, IBCLC Maryland, USA
> Date: Thu, 7 Mar 2024 06:14:20 -0500
> From: Lisa Bell<[log in to unmask]>
> Subject: Re: Unresponsive to pump
>
> Thanks everyone for your suggestions. I had her trying everything that was suggested. She did have some improvement but still wasn’t able to empty with the pump. She called me today and said that she noticed that she was developing the beginnings of blocked ducts that disappeared with massage while nursing. She is going to try taking lecithin. Not sure if this is the cause or the result of the milk stasis but we shall see..
> Thanks for all the help both on lactnet and with emails!
>
> Lisa
>
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