What's in your breastfeeding consult bag?

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From day one when I started visiting mothers at home to help them with breastfeeding problems, I always had a bag handy full of supplies. Of course, in the beginning the bag starts off ridiculously full and then as you gain more experience, slowly you discard unnecessary items and keep the worthwhile ones. Here's a look at what I carry around (yes, the bag stays in my car because I'm often called after work to consults)

• Hand Sanitizer: I always either use hand sanitizer or ask my mamas permission to wash my hands once I reach their residence before I touch either any babies or breasts. 

• Gloves are an important item in my bag. Before, I used to handle mothers and babies without gloves but after my mentor had an experience with a mother who had a communicable disease, common sense hit us that for our safety and that of the mother and baby, we should wear gloves. 

• Most of the cases I see are cracked nipples. Some are worse than others. I always carry around a tube of lansinoh in case the mother needs some to use until her nipples heal. This stuff is a godsend!

• Small hair dryer. Here's a tip you learn as go along. Cloths soaked in warm water are often used for engorgement but my little friend here works miracles! Combine it with the following item and your mama can finally get relief of painful melon like engorged breasts. Make sure to stay in tune with the mama so as not to burn her!

• A comb. This simple comb, combined with the blow dryer does wonders for a mama needing relief of engorgement. Simply hold the hair dryer at a comfortable distance and setting and comb from the top of the breasts gently to the nipples and repeat going full circle

• I call her "old faithful". My pump has been with me through many replaceable parts and mamas. Sometimes the mom wants to learn how to pump, sometimes she needs to take the edge off some pressure in her breasts, or to help erect the nipple in case of flat ones

• I also see a lot of nipple confused babies who absolutely refuse to latch. In those cases, after the mom pumps (or if she chooses to use formula) I teach her a handy method we know as cup feeding. 

• Homemade "Nipplette". This is probably my most prized possessions. Ina May's 2010 book "Ina May's guide to breastfeeding" featured how to make a nipplette by using an oral syringe and cutting off the long part and inserting the stopper the "Wrong side". Fit the nipple into the smooth side and gently tug to erect flat or inverted nipples. Success rate : nearly 100%. Cost: 1 Florin, compared to the 65 (nearly 30$, ouch)  Florins Avent's Nipplette costs. 

• In case the mom pumps, and she wants to store her milk but wasn't anticipating expressing milk to begin with. Pre-sterilized milk storage bags

• Breast Shell : Just in case my mamas want to catch their milk from one side while they pump the other. This also helps relieve pressure and draws out nipples subtly

• Hand Towel : I get milk on me often. I've had it drip on me, puked on me, and even squirted on me from a distance. 

• A stretchy newborn wrap : Many times, I don't know what mood to anticipate the mother and baby in. Sometimes the mother is home alone (dad at work, or single mom) or she's frazzled, or the baby has had a rough birth experience. Whatever the cause, I keep my wrap handy in case I need to give the mom a break and the baby some closeness and warmth. This usually gives the mom a chance to regroup and get her bearings together and recount her birth and breastfeeding experience or just to let all her emotions out. 

Are there other items you keep in your postnatal visit bag specifically for breastfeeding moms?