Sometimes when a mom is severely engorged, the interstitial edema
pinches off the milk ducts, making pumping difficult.  In this case, I
like to have mom apply a little ice to the breast (but not the nipples)
for about 3-5 minutes, then immediately pump.  Sometimes the first
pumping needs to last 45 minutes or so, to get the milk moving and the
edema relieved.  Then she is instructed to use the ice and pumping
routine every few hours until the milk flows readily and the breasts are
comfortable.

Another possible culprit is the thyroid removal.  Lisa Marasco has been
studying the relationship of polycystic ovary syndrome to breast
development, and one of the things she learned is that thyroid hormones
are necessary in at least one stage of breast development, and that even
"low normal" levels of thyroxine can impede breast development.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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