Coquelet & Punger Family Medicine P.A., Ft. Pierce, Florida

LETTERS FROM MOMS

Denise, Thank you for your kind attention to Isabela yesterday. I appreciate you honoring her for who she is - a highly sensitive, intelligent child, and giving her the space to come to you and develop a relationship on her own terms. Isabela actually said in the parking lot when we left, "I like the doctor." She then waved goodbye from the car, saying "Bye, bye Doctor Woman." Last night she was checking my ears, and she allowed me to check hers.

Perhaps quarterly wellness visits may be in order just to build her confidence and comfort level. What do you think?

Lisa (mom of 2 1/2 yo bf Isabela) in Clermont, Florida

I called to make an appointment with Dr. Punger on her day off and she came in to see me. Iwas so emotional. Nothing was going right for me. Both nipples were cracked and sore and I had a bilateral mastitis. Dr. Punger put me at ease from the moment I met her. I unloaded everything on her. I often wonder if she’s has seen anyone like me. But I felt comfortable with her from the start. She was so patient and calm with me, like no other doctor ever before. We talked about my problems from the breastfeeding to the vaginal disfigurement, to my depression. She spent a good hour and a half with me. Come to find out that we lived in the same neighborhood. She even came over later that night to check on me. I knew that I was so blessed to find her. My daughter will be a healthier person because of Dr. Punger.

It's weird when I first started the fluconazole the pain on the nipple,
from it being cold, went away right away. But now it's back. Is that because I have both the yeast infection and Raynauds? What else
could I possible get?? I'm sure there's some West African booby
disease I have yet to catch :)

D.B., Delray Beach

I thought you might like to know the progress that Nadia has made since you clipped her tongue-tie on November 1st. She is eating so well and growing so fast. She has also been sleeping through the night since the day after her tongue-tie was fixed. I have been telling everyone what happened with Nadia. I think it is horrible that women are robbed of breastfeeding over something so simple to fix. Thank you for helping us, you are truly a blessing.

Amy Dolan, Stuart

I just wanted to thank you for all of your help on Wednesday. I am amazed at what a remarkable woman you are. I cannot believe how much I relate to some of the things I have read on your website. I am so happy that I have found you (thanks to Alanna Rubin). I know that when I came in I had a list that went in one too many directions... I had taken Katelyn to a sleep specialist. Looking back, I know this was a terrible mistake. He labeled Katelyn with a behavioral problem and that she needed to be let to cry in her room the week we were getting a hurricane. I am so glad that I didn't listen. I have continued to listen to that maternal voice deep within myself despite outside forces. I want to thank you for strengthening my inner confidence. It is hard to stay on a path that everyone tells you is wrong. I amazingly have continued to stay strong in my beliefs. I will be going to some of the LLL and ICAN meetings. I just wanted to thank you for opening up a brand new light for me. It is nice to know that there are many people out there that feel the same as I do.

Warmest regards, Amie Scott, PSL

I was just thinking today about all the troubles I had at the beginning with breastfeeding and how I am so happy that I stuck with it. I am really enjoying my breastfeeding relationship with my daughter now (even with two bottom teeth and two on the top coming in!) and I know that I probably would not be breastfeeding today if it weren't for you fixing her tongue-tie! The Ped’s and ENT’s around here said it didn't affect breastfeeding (ha!) but they would be happy to fix it under general anesthesia, which I did not feel comfortable with. It was worth a 1 1/2 hour drive. You really are a great doctor who cares about her patients (and just cares about moms in general, it seems!). We need more doctors like you around. Thank you again for all your help. I’d drive 6 hours if my next one is tongue-tied.

Kristen, Tallahassee, was WBP

I spoke to my son and they are so glad they came to see you! Thank you for helping them. I was concerned that they would give up and I know that it gets easier as you go. I nursed both of my children until they were 18 months. Never owned a bottle and neither of them turned to sucking on a pacifier, fingers or toes

Great job! And thank you again!

Z.R

Thank you so much for helping M. and myself with the breastfeeding. I am happy to report that this morning, I was able to breastfeed her with very minimal assistance other than her own hunger. She fed for 10 minutes. I was so proud of her. I am already recommending you to my friends.

~T.F.

After the initial diagnosis of Galactosemia, my daughter discontinued breastfeeding completely for about a week - having been warned that it could cause terrible problems for the baby; then, there was a period when she was trying to breastfeed and supplement with soy to keep the galactose level down. The Dr. suggested that they do one of their tests at the very end of the feeding cycle (i.e. just before she was ready to nurse again) and that test came back with good results, indicating that her 25% (or thereabouts) of the enzyme was able to sufficiently metabolize the galactose. Subsequently, my daughter resumed full-time nursing with no supplementation; the baby is still nursing, beginning some solids(she'll be 10 mo. old on 2/7/07); she's around 23lb, 30 inches tall & beginning to walk (holding on). The picture ( which I hope is attached) was taken last October - so she's even bigger now (and cuter!).

Rita from Hobe Sound.

Our family just wanted to say thank you for going way above and beyond anything we ever expected from a family doctor. Without you I probably would have given up on my breastfeeding mission days ago not only out of hopelessness and frustration but also due to the lack of knowledge that there is help available. Until we stumbled into your office our understanding of breastfeeding was that you either have the knack or you don't - a belief I think a lot of new moms unfortunately share.

I always feel such relief when we leave after a visit at your office because it reassures me that it isn't my capabilities as a mother that lack, but rather it is a lack in knowledge and support available to women. From the time our baby was born a week ago every step of the way has seemed like a road block to a successful breastfeeding relationship with our child - whether it was discouragement from hospital staff, available information that never made its way available to us, or even a total disregard of our wishes to strictly breastfeed breastmilk from other medical professionals! All in all we owe you a great deal of gratitude. We are looking forward to a great relationship with our family practice. We are at peace knowing that we will always have all the information and options available to us when it comes to our health and will never be "pushed" into anything in regards to our health - the most important thing.

Thank you!
J, D, and little Luke

Update: The Lact-Aid is working great! I actually have nursed the baby while lying in bed!!! It has been nice, as nursing is not feeling as restrictive as before. I very much like the positioning of the system... I can use it as is without having to tape tubing all over my breasts as I had been doing since the other system. He took to the Lact-Aid right away. I was concerned it would be harder for him to get the supplement as the system works against gravity as opposed to what we were using... but he has no problem at all. In fact it almost seems easier for him with this new system. The only down side to this is that he doesn't have to suck very hard at all (at least not what I am used to)... which may be the proper way to nurse for most... but he isn't really getting out the breast milk as he is using the supplement. Before when I would pump following a feeding there really wouldn't be anything left from the breast I nursed with where as with this system there is still almost an ounce so he really isn't taking much breastmilk. I have been trying to nurse for a little while before giving him the supplement but many times he is very impatient. The only time I can really do this and he gets a good portion of breastmilk is during his early morning feed when my breasts are very full (a wonderful feeling I wish I could duplicate more throughout the day ;)

He is doing a lot of comfort nursing... lots of times he insists on this to go to sleep so I am sure he is getting a little then. I am trying to keep up with the pumping but it is very time consuming and hard to get to as the baby is awake more of the day more and more so some days I can pump four or five times a day and then other days I never really get to it. But I figure it is more important to cuddle and play with the baby rather than put him down to use the breast pump. The only bad thing is I notice a definite decrease in supply if I have to slack off on the pumping. Maintaining the system is not too bad. At first glance it did seem like a lot of parts and up keep but it is no worse than what we had before. After figuring out how to disassemble to sterilize before the first use it is a breeze. You just have to be careful because there are some small parts that you wouldn't want to loose down the drain! So I highly recommend!

Thanks again for all your help and support! I am enjoying my breastfeeding experience way beyond what I could have ever hoped for. I am glad I didn't give up! Thankyou!

Jen Cuti, PSL

I emailed to tell you thank you for helping me out. I really do feel a lot calmer again. I am getting things done and enjoying Asela so... very much. I am sure glad there was a solution other than not breastfeeding anymore. I also wanted to know when you needed to see Asela again. She was 9 weeks this Wed. And being that this is my first baby I do not know when she needs shots and all of that. That of which I also do not trust all I read. Your judgment matters most.

Thank you very much.
Peace and Love Always,
M. and baby Asela Jade Love, Vero

Good news! The herbal nipple cream is already providing relief! I've used it after each feeding since we left your office (approximately 3 times on each side). Hunter continues to latch on without hesitation. He doesn't appear to be bothered by the cream or even notice it's there.

Once again, you've made all the difference!
Thanks!

K, J, and Hunter, Vero

First of all I want to wish you Happy New Year. Also I need to apologize for not letting you know before that we were moving. We are now leaving in Switzerland, and as you can imagine, this was a big move for us, and everything happened so fast that we did not have a chance to say good-bye. We want to thank you for the wonderful service that you provided to us, and we want to let you know that it really was great to have you as our first pediatrician, we will miss you for sure. Hope to stay in touch

Sincerely, Carla and Chris

Great News - Olivia has had three of her best feedings yet, since buying the nursing pillow from your office! It was all about the position and placement. Thanks for your help! H.D.

I thought I'd drop you a quick email to let you know how well Alexandria is doing. I've been meaning to do it for some time, but she's quite a handful & I don't find myself with much time to spare these days!

After she got out of the hospital [for slow growth and developmental delay] we continued to supplement with formula using the Medela SNS. I rented a hospital grade breast pump & tried to pump to help increase my milk supply, but I wasn't successful with pumping. Things weren't going that well at first; she didn't like taking the formula even though it was attached to my breast & mixed with my milk (we refused to give her a bottle as so much damage was already done from the hospital not letting me nurse her during her stay there). She fought it every step of the way and my milk supply didn't seem to be increasing. Desperate, I went on line & found the Lact-aid nursing trainer and, as a last ditch effort, I decided to give it a try. It was the best thing I ever did. I have no idea what the big difference is between the SNS & it, but somehow she could tell and, while she still wasn't crazy about the taste of the formula, she began to nurse much better. Within a very short time, more & more formula remained in the bag after each feeding. When she was about 4 1/2 to 5 months old we no longer needed to use the trainer. Hooray, success at last!

Alexandria is an amazing little girl. She's still not a good eater, though! We still struggle to nourish her as she just doesn't like to eat or drink much of anything (she just hit 22 lbs today!). She's extremely active & did everything early. In fact, she took her first steps at 8 months old. By the time she went to the doctors for her 9 month check up, she was such a steady walker that the doctor & his staff were floored by her! She also knows how to communicate through sign, which has been a big help in keeping her frustration level down when she wants something (she has quite a temper & a low frustration threshold!). It was a long, hard road, but we made it through and now at almost 17 months, we're still nursing about 3 times per day. We're trying to gently wean so that we can try for another baby before my clock stops ticking! It's a little bittersweet, though, considering how hard we worked to get her to nurse. We're very grateful to you and all the others who supported us & helped us through.

Hope all is well with you and your lactation practice.

Sincerely,
Amanda, Damon & Alexandria Paxton, PSL

Where should I begin? This past week was one of the toughest in my life. I didn't know what to expect and I had certain baby "goals" I wanted to meet. When they didn't occur, I begun to feel even down. I thought I was incompetent ... I was crying and not sleeping. Definitely not a good combination. My mother in law decided to call La Leche League after I had kept putting it off. I didn't think there was anyone out there who would listen to my crying day and night. My poor husband. Then my mother in law said that someone had contacted her immediately ... it seemed a little too good to be true. I called your office ... and they asked me to come right away! That you were there. My husband turned around and picked me up ... and our baby nursed all by herself for the first time! We were tired and disappointed that she had to go to the ER the day before. After getting to be in your relaxed atmosphere of an office and being around someone who believed that I could do it (my husband knew that I was letting myself down due to expectations I didn't feel I was meeting and he was praying for me .. and the baby's mouth :)

.... my frown really did turn upside down and from that afternoon on, I wasn't weepy anymore! Anyway, all that to say that I am really thankful for your care and you’re listening ears. Oh, by the way ... I apologize for our last visit ... I kept sitting in your office not realizing that we were all done. I would have gone sooner :) You are definitely very patient with us and have been an answer to prayer. I've never thanked a "Dr." like this before ... but ... "Dr.'s" are known for being cold ... a trait that you don't have! Thank you for the beautiful pictures and I can't wait for the sling Regena, from your office, is making for me. I love sharing closeness with the baby. Have a wonderful day and we'll see you soon!!

Catalina, Chris & Elise :D

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