This is just my theory based on observation and some on the science of how
our lymphatic system works.  Women with smaller breast are more likely to
exhibit more noticeable primary engorgement than women with very large
breast.  The smaller breast has less adipose tissue and the milk glands are
closer to the surface, therefore there is less tissue space to expand with
the filling from the lymphatic system.  Women with large breast describe
increase heaviness in their breast but I rarely find them with severe
engorgement compared to women with the smaller breast.
Now if a woman feeds the baby very frequently then the engorgement is less.
Where I find this dilemma more challenging is in the areola.  In the smaller
breast the areola gets much firmer during engorgement than the larger breast
and therefore babies refusing to latch on day 4 when they were doing fine in
the hospital.
I am curious to what Jean and Barbara think of this theory.
Ann Perry RN IBCLC
Boston, MA

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