Hello, Gloria. We haven't heard from you for a long time.

I agree with Patricia Drazin that Rescue Remedy could help in this case. I
will re-send a post that I sent a few years ago when I had a case of severe
engorgement. Hopefully it will be of help to you. [For more information on
Rescue Remedy you can search the archives.]

In a second post I will re-send a post that followed the original one. It
is a follow-up report.

Patricia Gima, IBCLC
Milwaukee, Wisconsin
_________________________________________________________________________
ENGORGEMENT

The subject is in all caps because I'm trying to impress upon you the horror
of the engorged breast I saw last Friday (day 6 after birth).  This woman
is a small woman and her breasts were wider than her body.  Together (and
they were so tight
together that it was hard to get cabbage between them) they spanned over 20
inches. She was in such pain and had been so since Tuesday morning (day
3).  She got no relief from the limited measures at the hospital, except
for powerful pain medication, and was discharged with no hope for resolution.

I've never seen, even in the most extreme pictures, such distorted tissue.
It was actually lumpy (severely pitted)on the surface.  She had a c-section
and little
breastfeeding assistance.  At the hospital they offered her a pump from
day 4  and nothing would come out. She was very frightened by all that
happened at the hospital.  She is Spanish speaking and there was noone there
whom she could communicate with.

I arrived with my head of cabbage, some ibuprophen, and Rescue Remedy
(which helps to stimulate an MER (let down). She was able to pump about 1/2
ounce from each breast and we applied the cabbage.  Within half an hour we
smelled steamed cabbage and we changed the leaves.  It took a lot of cabbage
to cover the surface.  I left her with instructions to pump every 2-3 hours
after warm compresses and R.R. and to take the ibuprophen every 4 hours and
to change cabbage every pumping.

The next day she was feeling sooo much better-- no pain-- and was pleased
that the swelling had gone down some.  She was no longer "frying" the
cabbage. She was glad that she had been able to discontinue the pain meds. as
they were making her groggy.  Today I returned and the breasts are still
huge but less so and are a bit more moveable.  We were able to get the
cabbage between the breasts with ease. She is pumping about 1-1 1/2
ounce in 10 mins of pumping.

You may wonder about the baby's feeding at the breast.  Well, she has been
so traumatized by all of this that she is determined to not breastfeed the
baby.  She has been using abm since Tuesday when the engorgement began. She
is afraid that if she feeds the baby it will get terrible again.  She just
wants her breasts to go back to where they were. All she wants from me is to
resolve the engorgement and to not talk about breastfeeding. That's what I'm
doing. When things are better I will see if she is still determined to feed
abm and I will respect her wishes.

What I want to know is why did this get so extreme?  I know that some women
decide to not breastfeed and they don't get like this.  Has anyone seen this
and do you know what causes such severe swelling? Is it likely that it will
happen with another baby if the early days of breastfeeding don't go well?

Patricia Gima, IBCLC
Milwaukee



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