re the Korean mom who isn't making milk--I too have had experience with Asian
moms with very tight breast tissue, very little to no expressible colostrum,
engorgement which is not relieved with nursing or pumping and then no milk. I
have a hunch that this unrelieved engorgement, coupled with the picture of
very tight breast tissue, leads to involution. Or maybe it is the very tight
breast tissue which leads to severe engorgement which is difficult to
impossible to relieve before the milk dries up.  I agree with Barbara Wilson
Clay that there is something in the mechanics of breastfeeding that we are
missing here. If we could somehow figure out how to prevent this severe
engorgement in tight breasts or at least how to effectively relieve it in a
timely manner, I think we might see adequate milk production. I'm wondering
if very early intervention when we see this type of breast tissue--ie.
frequent pumping if baby is not able or willing to breastfeed often would
make a differnece--but then again could this make it worse?  What do others
think?

Kathy Boggs, RN, IBCLC

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