If the mother is continuing to have problems with breast fullness for this length of time it may be severe edema that is bothering her and not necessarily an overproduction of milk. I'm not sure that sage tea will help because I believe that is supposed to reduce milk production, not reduce edema which is due to excess fluids trapped in body tissues. Or does anyone know if this reduces fluid trapped in tissue, too?
Many mothers mistakenly feel that the more engorgement they have, the more milk they have, but I explain to them that this may not necessarily be true. I think that it's possible to have a lot of swelling and not a lot of milk, and conversely - a lot of milk and not a lot of swelling, or sometimes a lot of swelling and a lot of milk. Because breast fullness can be caused by blood, fluids and milk, it can be any combination of those things that causes the feeling of fullness for the mother. If it is continuing beyond a couple days, I think it is more often due to body fluids (edema) than due to milk production. 
If she had excessive IV fluids, pitocin or preeclampsia she's at greater risk for severe edema. If it's edema, you may find a pitted orange peel appearance to the breast, instead of it being tight and shiny. Also, if she tries to pump, there is little milk removed and she has little relief. Although sometimes you can try reverse pressure softening before pumping and have more success. But I have found that sometimes pumping makes the swelling from edema worse and that hand expression is more successful. Also, another way to tell is if applying heat helps before milk removal it is probably engorgement. If applying heat makes the swelling worse, it's probably edema.
The best thing I've found to relief edema is cabbage leaves. It works like a charm and the mother usually feels relief within 30 minutes. It works great for both edema and engorgement, and of course motrin can be helpful, too. Good luck to her, I hope she feels better soon.
Tricia Shamblin, RN, IBCLC




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