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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

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by Diana Cheng Scheible, MA, OTR/L, CLE, IBCLC

Carpal tunnel syndrome (CTS) is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works, numbness, tingling, and pain may be felt in the hand and fingers.

Fluid retention during pregnancy can cause symptoms of carpal tunnel syndrome, which often go away after delivery. However, some women report exacerbated symptoms after delivery due to continued early post partum swelling and the constant bending of the wrist in baby care. There may be a combination of causes of CTS including arthritis, fractures and irritation due to repetitive, prolonged, and/or forceful motion (for example: a roofer pounding nails, a computer user keeping wrists constantly bent).

Carpal tunnel syndrome symptoms usually include pain, numbness, tingling, or a combination of the three. The numbness or tingling most often takes place in the thumb, index, middle, and ring fingers. The symptoms usually are felt during the night but also may be noticed during daily activities such as driving or reading a newspaper. Mothers may sometimes notice a weaker grip, occasional clumsiness, and a tendency to drop things.

Treatment

The first step is to call your doctor for assessment and proper diagnosis of your symptoms. Patient education and proper body mechanics are key for minimizing carpal tunnel symptoms.

  1. Maintain the wrist in a neutral position with daily activity. After you latch your baby, avoid using your hand and wrist to support your baby's head during the feeding. Instead, use a rolled up blanket or small pillow to avoid positioning the wrist in a prolonged bent position.
  2. Since we often sleep with our wrists bent in a 90 degree angle (fetal position), wearing wrist splints at night can be very helpful to decrease pressure on the nerve and reduce swelling and symptoms.
  3. Avoid positioning the wrist in a bent position while sleeping or sleeping on your wrists, once the wrist immobilization splint is discontinued.
  4. Avoid a sustained pinch/grip and awkward motions, particularly with the wrist in a bent position.
  5. Identify and treat medical conditions such as thyroid conditions, rheumatoid arthritis, and diabetes which can be associated with carpal tunnel syndrome.
  6. Take rests and stretch breaks from activities to prevent overuse of repetitive motions.
  7. Anti-inflammatory medications, such as ibuprofen and other nonprescription pain relievers, may ease symptoms that have been present for a short time. Please consult with your physician regarding any medications especially if you are pregnant or breastfeeding.
  8. Some mothers find pain relief with the use of paraffin wax baths. Dip both hands and wrists into the paraffin wax 4-5 times and relax for 10 minutes. Home use paraffin bath units can be purchased at places like Bed Bath and Beyond.
  9. You may also feel pain relief with Contrast Baths which can be done 2-3 times per day. The purpose of contrast baths are to assist with reducing inflammation along the wrist, which may serve as the contributing factor for the carpal tunnel symptoms. In addition, the contrast baths facilitate blood flow and thus helps “pump” the swelling out of the hand and wrist.
How to set up a Contrast Bath:
  1. Prepare one basin of hot water (to your tolerance)
  2. Prepare one basin of cool water with ice
  3. Immerse your hand/wrist into the hot water for 2-3 minutes
  4. After 2-3 minutes, immerse your hand and wrist in cool water for 1 minute
  5. Repeat steps 2 & 3 two more times always ending with your hand/wrist in cool water.
  6. If pain, numbness or weakness recurs and persists, return to your physician.

Some people find that a rehabilitation program designed by Occupational Therapy Hand Specialists which include education of ergonomic principles particular to their daily activities, nerve glides, stretching, splint fabrication and treatments such as paraffin wax treatments, ultrasound, and electric stimulation can minimize carpal tunnel symptoms. Additionally, alternative therapies including acupuncture and chiropractic care have benefited many people.

The Pump Station & Nurtury® has decades of experience providing new families with outstanding educational, breastfeeding and baby care support, including products and classes which can make all the difference to you and your baby. To see a list of some of the essential products that our Lactation Professionals have recommended, click Essential Breastfeeding and Baby Care Products


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© 2006 American Society for Surgery of the Hand. Developed by the ASSH Public Education Committee. Reprinted with permission of the author. All rights reserved. No part of this handout may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, without permission in writing from The Pump Station & Nurtury®. 11/07
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Breast Pumping Guidelines

Breast Pumping Guidelines
There are many reasons women pump their breasts to provide milk for their babies. Some are separated from their hospitalized newborns and must pump to provide the many benefits of mothers' milk. Others must return to the workplace but want their babies to continue receiving breast milk. Whatever the reason, mothers have many questions about the pumping process. Continue reading

Video: How to Increase Milk Supply

Video: How to Increase Milk Supply

Corky Harvey, RN, MS, IBCLC explains why so many women worry that they aren't making enough milk for their babies and what they can do about it.

 

 


Essential Breastfeeding Support and Baby Care Items

The Pump Station & Nurtury® has decades of experience providing new families with outstanding educational, breastfeeding and baby care support, including products and classes which can make all the difference to you and your baby. To see a list of some of the essential products that our Lactation Professionals have recommended, click Essential Breastfeeding and Baby Care Products

 

See Other Breastfeeding and Baby Care Help Topics

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Videos: Common Questions About Breastfeeding

Videos: Common Questions About Breastfeeding

 

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How do I know if My Baby is Getting Enough to Eat?

Published on August 2014
Corky Harvey, MS, RN, IBCLC answers a common question from nursing mothers, "How do I know if my baby is getting enough?"

 



When to Start Pumping?

Published on August 2014
Wendy Haldeman, MN, RN, IBCLC answers a common question from nursing mothers, "When do I start pumping?"

 



How to Increase Milk Supply While Working?

Published on August 2014
Barbara Zimmermann, RN, BSN, IBCLC, CEIM answers a common question from nursing mothers, "How can I increase my milk supply while working?"

 



Does it Matter if you Mix Breastmilk with Formula?

Published on August 2014
Wendy Haldeman, MN, RN, IBCLC answers the question: Can you combine breastmilk and formula?

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Breastfeeding including classes, support groups, breast pumps, certified lactation consultants and more.

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Video: How to Breastfeed - Deep Latch Technique

Video: How to Breastfeed - Deep Latch Technique

 

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Originally Published from Fit Pregnancy Magazine:

A step-by-step video with tips on "How to Use the Deep Latch Technique" from Corky Harvey, RN, MS, IBCLC a lactation consultant at The Pump Station & Nurtury™

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Video: How to Use a Breast Pump

Video: How to Use a Breast Pump

 Originally published in Fit Pregnancy Magazine:

A step-by-step video guide on "How To Use a Breast Pump" from Corky Harvey, RN, MS, IBCLC 

 

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Breastfeeding including classes, support groups, breast pumps, certified lactation consultants and more.

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Video: How to Breastfeed in Public

Video: How to Breastfeed in Public

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Published on 2008:
A step-by-step video with tips from Corky Harvey, RN, MS, IBCLC and Wendy Haldeman RN, MN, IBCLC 

 



Published 2009:
Answers from Corky & Wendy about nursing clothing and gear:
  • What are the easiest clothing options for breastfeeding moms?
  • What's a nursing cover-up?
  • How do I use a blanket if I want to cover up while breastfeeding in public?
  • How can I use my sling as a nursing cover-up?
  • How does a built-in nursing bra work?
  • and more
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Breastfeeding Tips for the Working Mama

Breastfeeding Tips for the Working Mama

by Linda Mansolillo

Returning to the workplace while maintaining an adequate milk supply can be very challenging. One of our amazing mothers was very successful in her goal to provide her baby with ample breastmilk while working full time and traveling. Linda Mansolillo has generously taken time out from her hectic schedule to compile a long list of invaluable tips for pumping while traveling and working outside the home.

General Pumping Tips for the Working Mama

  • Keep baby reminders with you, videos, lovies, pictures to help you remember this amazing person you are doing this for
  • Keep a supply of scarves in your car/tied to your purse for coverage if you need to pump in unexpected places
  • Pack extra zip lock bags to separate dirty parts
  • Pack the night before as you are less like to forget something
  • Invest in a manual/hand pump in case your electric one breaks
  • If all else fails hand express in a bathroom after you've put some warm towels on your breasts to help release milk
  • Be an advocate for your pump time- that meeting you need to leave to pump is not more important. No one needs to know why, but just make sure you make the time
  • Try to squeeze in an extra pump at home, if you can, early in the morning after the baby has fed, or if your milk supply is high, pump one side and feed the baby on the other. This is a great tip to build up extra bottles quickly!
  • Have a shirt/bra stash for a random leak accident
  • Dress for a successful pump, meaning any top or dress you can get to your breasts easily. Be wary of silk if you don't catch the milk drips as it will leave a stain
  • Consider bottle bags with ice packs built in so you can toss and grab from freezer (not recommended for travel as TSA will require any ice pack not completely solid to be thrown away and you don't want to lose your whole cooler)
  • Place flanges and pump parts in the refrigerator between pumps so you don't have to wash them until the end of the day
  • Buy Medela Quick Clean Micro-steam sterilizing bags for extra convenience and good cleaning
  • When finished pumping have a towel either on your lap or ready to catch the drips as this can save clothing changes and or stains
  • Keep a full set of pump parts at work
  • Invest in a car charger and battery pack- many women pump on the drive in
  • Consider renting a bigger pump to keep in your office, or check to see if your office has them available
    We rent Hospital Grade Breast Pumps.

Travel Specific Tips for Working Flying Mama's

  • Buy a spare AC wall plug, a battery pack, batteries, and plane charger. You may need all options aircraft dependent. If you travel a lot make sure to test the batteries before you leave or have a spare set. Also note that some battery packs require 8 batteries (4 per side)
    We only carry a few pump parts on our website, but call either of our stores and we'll be happy to gather up what you need for pickup, or call the Hollywood store and we can have what you need shipped. Santa Monica: (310) 998-1981 Hollywood: (323) 469-5300.
  • Invest in lots of ice packs as you may be forced to throw them away if they are not frozen solid by the TSA, or as leaks may happen during transportation and they become dirty.
  • If pumping on the plane in the restroom let a flight attendant know, so they don't get concerned
  • Don't be afraid to pump in your seat- airplanes are extremely loud so you can't hear the pump. Bring a blanket, scarf, or in a pinch ask for an airplane blanket
  • Consider pumping one side at at time on the plane into a larger bottle so you can stick it right in the cooler and avoiding taking too much cooler space and/or having to pour the milk on the plane
  • Don't be afraid to try and pump in nice places if you're traveling- hotel ladies room lounges, airline lounges etc. One great spot is some lounges have showers you can use, which is a nice private room with water and plugs. A good backup is the family restrooms
  • Baristas and flight attendants will give you free ice if you need it while traveling
  • Buy and travel with milk storage bags, they take up less space in your cooler but bring at least two bottles for pumping on the plane, and so you have alternatives
  • Use your flange as funnel to pour the milk into the bags
  • Make sure you know milk transport guidelines- for example milk is good in a cooler for a TOTAL of 24 hours, so you can transport your milk, store it at your hotel in a refrigerator, and then transport it on a cooler back home as long as it is not in the freezer bag >24hrs
  • Call hotels ahead to make sure you have a refrigerator with a freezer in your room- they normally will charge you nothing if you say it is for breastmilk. Some minibar refrigerators are cool enough
  • If your hotel room doesn't have a freezer you will likely get push back from the hotel about freezing your ice because of food storage laws, so pack extra bags so you can make new ice packs if needed
  • Check to make sure your milk storage bags have little air and are sealed properly as the cabin pressure may cause them to open and leak
  • Plan to spend about 10 minutes longer then normal getting through security even with TSA PreCheck as they may want to do additional testing
Essential Breastfeeding Support and Baby Care Items
The Pump Station & Nurtury® has decades of experience providing new families with outstanding educational, breastfeeding and baby care support, including products and classes which can make all the difference to you and your baby. To see a list of some of the essential products that our Lactation Consultants have recommended, click Essential Breastfeeding Products

See Other Breastfeeding and Baby Care Help Topics

This article has not been prepared by a physician, is not intended as medical advice, and is not a substitute for regular medical care. Consult with a physician if medical symptoms or problems occur.

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