Dear Friends,
I am in need of your collective wisdom.  I have been speaking to a mother who has been suffering from acute engorgement in one breast on and off for the past 6 weeks.  She is almost exclusively breastfeeding an 8 month old.  Six weeks ago she called me panicky because her breast had become swollen "rock hard" and extremely painful.  She says that there is no redness and no lumps. Only the lower quadrant "underneath" is not affected.  She does not develop a fever or flu like symptoms.  She has been feeling run down for some time now.  She had blood work done a few weeks ago and her lymphocyte percentage was a bit high; 47.8%  and neutrophils a bit low (41).  The next day the engorgement began again.  Could there be a connection here?  Her doctor feels that she has recently gotten over a virus. The first time we spoke, she denied anything out of the ordinary on her nipple but has since noticed a "blister" on her nipple tip every time she experiences this engorgement.  The first time she called I gave her tips for dealing with engorgement and it passed.  One month later, it happened again.  She started to treat it as soon as she felt it happening but nothing helped.  It resolved in 24 hours.  A week later it happened again and now 6 days later it has started again.  She called me for the second time today.  I suggested she start lecithin immediately according to Dr. Newman's recommendation as written in the Answer Book and to treat the blister on her nipple like a plug.  It seems strange to me that almost the entire breast is involved if this is a plugged duct.  Another interesting thing, the mother noticed that the day preceding an 'attack', the babies diapers would be drier than usual, no poops at all, and the baby would want to eat more often than usual.  The mother is almost at her wits end but as she is a nutritionist, she can't stand the thought of abm.  The baby has been pushing away solids.  I would really like to know what others think and how to proceed.  
Thank you all so so much,
Chayn Fogelman, melting in Israel
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