34 years old
1st delivery
twins
started vaginal and ended c section
born 16.7.23 so now they are 15/16 days old
40+4weeks
only saw one baby who is the main "issue" for her
baby girl was born 2.950kg and is now 3.135kg
(you and I saw her in Shaarei Tzedek when she said she hired a private consultant to visit and guide her) (I also spoke with Inna at Hadassa Baby because Inna was concerned about what is going on with her as well)
She told me she never fully got organized what to do or why she does what she is doing. So she kind of ignored some advice and pick and chose what she wanted
They gave her a silicone nipple shield in the hospital because of inverted nipples. so she uses a suction to pull out the nipples and then the silicone shield. She wants to get away from the shield as well. she feels she doesn't have enough milk so she supplements with formula every feed (switching off which baby supplements depending on who ate first or second)
she seemed very uncomfortable. Baby girl sucked nicely on the nipple shield but struggled without. But it looked to me like a baby could have been capable of sucking on those nipples without the shield. she said she pumps 3 times per day but really doesn't get much. I told her she should try pumping for 5 min after every feed. She also said milk drips from the shield a lot and thinks babies really aren't getting enough excuse of that. I shoed her how to use the shield better. and get a deeper latch. I explained the shield as a bandaid and potentially harmful to her supply. I explained why a consultant would have given her a strict pumping routine initially because of the shape of her breasts are farther apart and shaped like V almost. So I told her she should try and pump for 5 min after nursing her babies for 2 weeks just to try and build up supply
also showed her side lying position with her baby because she was uncomfortable with a lot of the nursing twins for so long and she doesn't get to rest and she really liked it a lot.
she wanted me to do home visit but gave her number for other consultants who can try and help her later on eliminate the nipple shield.
I had told to the mom that she can try and let the baby latch on the breast when they aren't hungry to see if they are able to latch without the shield because its harder to do so when cranky and hungry. I wasn't sure if that was accurate. What would you have suggested I advise her?