Kathy Leeper, MD, IBCLC wrote:

"I have seen several moms lately who received a lot of IV fluids and
pitocin, who present with no milk at 5-6 days and are retaining a lot
of fluid.  (huge ankles) They appear engorged, but no milk is
removed. "

what you are seeing is not milk in the breast, but fluids (lactose etc.)in the interstitial space that has moved out of the epithelial cells from the Paracellular pathway V or the tight junction.  So, do not force pumping, to withdrawal or empty completely the breast, bc what the engorgement you see is the fluid in the interstitial space.  Express as much milk as you can,(by hand first, works the best) if the breast are still engorged, treat it with cold packs!!  Just like a dislocated ankle.


"..and the increased pressure inhibits lactogenesis. "

The increase pressure  (engorgement) compresses the blood supply, decreases the delivery of prolactin to the epithelial receptor and oxtocyn to myoepithelial cells.  Yes, this is the start of decrease milk supply or the inhibition of lactogenesis

ciao,
rosellina Cosentino rn bsn phn ibclc
 from sicily



 

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html