Hi Laurie T., I wonder if your 44 yr. old 1st time mom was a DES daughter. I have run into serveral cases where problems occur throughout the mothering continuum. First, difficulting with conception, then keeping her pregnancy. Usually, these women have had multiple miscarriages. When baby is born, many end up with c-section due to t-shaped uteruses. Then when baby is born, there are difficulties with lactation. Are her breasts notably different sizes. If yes, she is likely to only produce milk in the larger breast. Considering the swelling and edema, is she getting proper medical care? What have they turned up medically about her? Also, make sure her hospital grade pump is actually working. Have you seen any improvements since your last post? Debbie Albert, IBCLC