Several years ago, I had a client who also happened to be an old childhood
friend of mine.  After her baby was born, she got off to a seemingly good
start nursing, but soon called me in tears due to "engorgement".  I showed
up with a pump, etc.  Mom's breasts were hard, hot, etc.  All tricks and
ongoing use of the electric pump did little to help mom.  Doc even suggested
using anti-inflammatory, but mom's breasts remained very painful, hot, and
engorged off and on (mostly on) for 2 weeks.  Mom seemed very compliant w/
treatment plan.  Reported no unusual hx.  However, I recalled that approx.
17 yrs. earlier, when we were in early teens, she had some mysterious
surgery on her breasts. (  mysterious only because young teens are loathe to
discuss such topics!)  She then recalled that yes, indeed, she had surgery
to remove numerous "lumps".  Seems that somehow resulting scar tissue had
blocked ducts.  Possibly due to the surgery being during the time of
greatest breast development?  Supportive doc and I tried all the tricks, mom
deserved a gold star for effort.  We finally all agreed reluctantly that
mom's constant misery wasn't conducive to positive motherhood.  We helped
her wean very slowly, but she was miserable for a long time.  Her body
seemed to continue to make milk that was blocked from getting to the nipple.
I have seen similar situation in a mom who had one breast badly burned as a
child, and the nipple was gone.  One breast lactated great, but the other
one kept producing and there was no nipple and no way out! Both of these
cases broke my heart, as moms wanted to nurse.  I assume others have seen
similar situations?  Could there be scarring internally from some cause?

Jennifer Kneuss
Ohio...where it might get up to 50 degrees today! Come hither, Spring!