First I want to thank all who replied to me with such helpful and
fascinating information on this surprisingly common problem. I've learned
so much over just these past few days; I feel so fortunate to have such a
caring, knowledgeable group to lean on when I'm stuck.
I was sent information about edema and engorgement (maybe they're
interchangeable in this case?), and the suggestions to use cool compresses
and cabbage leaves, as well as try Reverse Pressure Softening (RPS) for
longer than I had been doing. It's so ironic that, what seems to be a
logical source for relief -- pumping -- can actually make matters worse.
Anyway, I gave the mom information on using cabbage leaves and cool
compresses, try RPS for longer (3m), and only pump on the lowest setting.
I'm also sending the mom information on hand expression.
I was hoping I'd be able to post an "all is well" email tonight, but I spoke
with the mom just a few hours ago and it's still not resolved. She said
she's able to pump only appx. 1oz total from both breasts, and she says they
are a little softer in some areas but still very lumpy in others...however
she also admits that she has only applied the cabbage leaves 3x today and
maybe once last night, after I sent her the information early yesterday. I
urged her to be more consistent and she sounded like she would, but I'm
starting to feel that she's stopped listening to me because I'm not fixing
the problem.
She did mention that, about 5 years ago, a gynecologist told her that her
breast tissue was very dense and that she would need an ultrasound rather
than have a mammogram to detect cancer. She described fibrocystic symptoms
and said she "weaned herself off" caffeine two years ago, then said she's
down to about 20% of her consumption before this "weaning". Could this be
contributing to the problem?
She also said she received at least 3 IV bags of fluids during L&D, and that
she did have changes during puberty (you remember she said she had very
little change during pregnancy, only about 1 cup size, and she's quite
small-breasted even now). She said she had NO swelling during pregnancy,
even at the end, and has NO swelling anywhere else in her body now.
I'm so worried that, since she delivered eight days ago, this ongoing edema
(if that is what's going on) could permanently impact her milk supply. I'm
considering sending her to an endocrinologist just to check out the mammary
tissue. Can anyone else provide another suggestion?
Thanks again for all your help.
Debbie Gillespie, rookie IBCLC, RLC, LLLL
Tempe, AZ
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