MY NAME IS DONNA NORRIS, I AM AN R.N. AND IBCLC AND WORK AS AN LC FOR A LARGE
HMO,HARVARD PILGRIM HEALTH CARE, IN THE BOSTON,MA. AREA.  I HAVE A PATIENT I
AM WORKING WITH THAT I WOULD LIKE TO DISCUSS WITH ANYONE WHO MIGHT BE ABLE TO
HELP.  THIS WOMEN IS 37 WKS. PREGNANT AND HAS A MASSIVE HYPERTROPHY OF HER
LEFT BREAST.  THE BREAST IS SO PROBLEMATIC THAT SHE HAS HAD TO TRAVEL TO
ANOTHER STATE TO HAVE SPECIAL BRAS MADE.  THE RIGHT BREAST HAS ALSO ENLARGED
BUT AT A DISTINCTLY DIFFERENT RATE.  THIS IS HER SECOND PREGNANCY.  SHE
REPORTS AN EPISODE OF MASTITS IN HER LEFT BREAST AFTER HER FIRST CHILD WAS
BORN 5 YEARS AGO BUT HER HISTORY IS VAGUE AND I WONDER IF SHE IS CONFUSING
PRIMARY ENGORGEMENT WITH MASTITIS.  SHE HAS BEEN EVALUATED BY A SURGEON WHO
DOES NOT FEEL THERE IS ANY MALIGNANCY.  THEY ALSO TOLD HER IT MAY HELP TO
BREASTFEED THIS BABY.  THEY MENTIONED THAT THERE MAY BE A LYMPHATIC BLOCKAGE
DUE TO HER FIRST MASTITIS BUT FEELS THERE IS NO INFECTION PRESENTLY.  THIS
WOMEN REPORTS ATTEMPTING TO BRAEST FEED HER FIRST CHILD BUT FOUND IT TOO
PAINFUL AND WEANED IN FIRST WEEK OF HIS LIFE.  HER BREASTS ARE SLIGHTLY
DIFFERENT IN SIZE IN THE PREPREGANT STATE.  ANY HELP WOULD BE GREATLY
APPRECIATED.
                               DONNA NORRIS RN IBCLC