Dear all: 
re: Jaye’s case:

My first thought was that mom’s milk did come in...

”She experienced her milk coming in on day 3 –
4 with extreme fullness but never pumped more than drops at that time – even
with pumping q. 2 hrs.”  

...but that the IV fluids in labour...


”Mom on IV Fluids for approximately 15 hours, given Pitocin at lowest levels for
approx. 10 hours, then an (light – Anesths words) Epidural for approximately
6 hours – 1 bolus and then a 2nd dose just before delivery when they
increased the Pit and then 30 min later, after 10 min. of pushing baby was
born”.

.....resulted in overall fluid overload/edema, including breast tissue and areola. The areolar edema would be exacerbated by pumping, effectively blocking off the flow of milk.  A perfect situation for RPS.(reverse pressure softening)
Inability to move milk could then result in involution.  
What do others think?
Doreen Vanderstoep, RN, IBCLC

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