Deb writes:

<Mom said breasts were soft until milk arrived on d3.  Now mom's breasts
are
not large but they are thick (if that makes sense) and feel engorged. 
Mom's
areolar tissue is so firm, reverse pressure softening and pumping do
little,
if anything, to soften.  Firmness to tissue returns within minutes of RPS
or
feeding, assuming we're even able to get baby latched on.  Nipples are
soft
and slightly flat but respond to stimulation.  Mom's areolar tissue is as
firm as the breast behind it, so baby only sucks on the soft nipple
(ouch).>



You are not the first person who has had this experience. I have
developed a set of additional comments on RPS in breasts with severe
pitting edema, etc. I will gladly forward it to anyone interested.

I would appreciate hearing if these further ideas help in your mom's
situation. I hope it arrives in time to do some good before the swelling
begins to resolve on its own. Pay special attention to the comments on 
utilizing gravity during and after RPS to facilitate latching. and 
the effect of pumping on the nipple-areolar complex and 
better ways to manage if pumping is actually necessary (e.g. mother-baby
separation.)

I am welcome all negative feedback on RPS, as I think the theory it is
still a work in process. Your detailed descriptions of times that it
didn't work as expected helps my thought process for future writing.

Jean
**********************
K. Jean Cotterman RNC, IBCLC
Dayton, OH USA

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