Hi. I am working with a mother, first baby, and baby is having trouble 
removing milk from her breasts. Actually, we can't get any milk to come 
out. Baby is 48 hours old and has a great latch and nutritive suck, but 
absolutely no swallowing. I have read previous posts about breast edema and 
how it may affect milk flow, but in this case there is no milk flow at all. 
Mom told me that she was leaking during pregnancy.  She had her nipples 
peirced, but I didn't think that would cause this type of problem.

She had a four day induction (off and on) then wound up with a c/s-so lots 
and lots of fluid and pitocin.  Her ankles and legs are very swollen.  Her 
breasts are fairly soft at this point.  The only thing that produced a drop 
of milk was RPS.  We tried RPS, warm cloth, pumping, massage, then baby and 
still no swallowing.  I couldn't even produce a drop when I hand expressed 
for her.

Can edema cause this?  Could the nipple peircing play a factor?  I didn't 
have her try ice, but encouraged her to do so at home as she was being 
discharged.  Thanks for any thoughts.

Christine Lichte, IBCLC, LLL Leader

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