Linda,

If the breast is hard due to fluid build-up, the cabbage leaves should help, as
well as using cold compresses (at the hospital we use diapers we wet down and
put in the freezer to chill).

Have you read in the old Womanly Art of Breastfeedings about the "juice jar"
method of expressing milk?  I have used this especially now with our electricity
erratic and moms have a lot of pain associated with hand expression during this
time.

This is not in the newest WAB, but it has saved many a mom (including my
co-leader and a mom I was talking to last Thanksgiving Day:

Get a jar the size they sell cranberry or apple juice (must be glass).
Mom must have dry and cold wet towels nearby also.
She empties the jar of the juice and washes it well (as some want to use the
milk for the baby later).  She fills it with very hot water.  Now she needs to
use the dry towel to hold the very hot jar. She applies the cold towels on the
top until the rim of the jar is cool and will not burn.
She puts the rim  to her areola creating a seal.
As the hot air in the jar cools it draws the nipple and areola into the jar and
gently pulls milk out softening the areola.  She can hasten the process by
applying the cool towels to the jar, but I usually don't recommend this as she
could burn herself trying to juggle between the original dry towels and the wet
ones.  My co-leader used to put the jar on the table and lean over it, using
cold towels then to cool the jar - some mom's backs would hurt too much, so I
let them know it is an option.
Last Thanksgiving I got a call from a mom with this problem and she was so
relieved after three sessions she was breastfeeding with no problem.

Another option, if you have access to 20cc syringes is to cut off the tip, put
the plunger in the cut end and put the smooth end to the nipple and areola then
_ have the mother_  pull on the plunger (I stress, without shouting, _have the
mother_  because she should be in control so it doesn't hurt).  Often if we can
get some milk and soften the areola the baby will be able to latch on.

Of course the old "nipple shield" can also be an option and even though it has
fallen to disrepute, I use them as moms here are NOT the dedicated breastfeeding
moms an LC comes in contact with (if she bothered to call and meet an LC - I
call that dedicated).  The moms I see at the hospital are "trying" to breastfeed
and if I can't get baby at least latched on during the first 24 hours in the
hospital  so they can see for themselves that they CAN breastfeed, they'll never
make it to call an LLLL or Dr. Ana Parrilla, MD, IBCLC.

Jeanette Panchula, BSW, LLLL, IBCLC, RN
Puerto Rico
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