<I just talked with a who mother had breast reduction surgery in 1987. >

Probably an older technique 15 years ago. Was the nipple removed? Perhaps
a change in circulation or nerve supply might be suspect.

< Though her nipples
are slightly smaller than a nickel, she says they swell>

I saw a veterinary reference not long ago that measured differences in
teats when high vacuums drew edema into the teat tissue causing them to
be swollen. Any scar tissue might make this tendency even worse.

< and turn purple with
pumping.>

This is cyanosis, outright. How high is the vacuum set? How long is it
holding? When circulation gets trapped so there is no outflow or inflow
of new blood, the blood cells begin to change from bright red gradually
turning to dark bluish-purple. Tissue waste is also not then leaving the
tissues, leaving pain and inflammation in the aftermath.

Is she able to hand express whatsoever? At least to stimulate a MER
before pumping on medium or minimum vacuum?

Jean
**************
K. Jean cotterman RNC, IBCLC
Dayton, Ohio USA

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