Oh my goodness! Is this ever a humbling experience!!!!!  Just when you
think you're starting to learn something about lactation, someone's body
proves you wrong!  I've been working with a woman who had severe
engorgement that lasted 5 days!  Her engorgement resolved thanks to
continuous cabbage, ice, and pumping and then putting baby to breast.  3
days ago she cancelled a weight check (bad move) because "things were
going so well....the baby was latching on every 2-21/2 hours deeply,
making lots of audible swallows and latching on deeping"....that she
wanted to postpone it so that she could attend to other things.
Primarily, she was engorged because she had a severe shoulder muscle
strain during delivery that was causing excrutiating pain and inhibiting
her ability to let down...She needed to go to her PT appointment in lieu
of her weight check.  Makes since...and things were going well.
Unfortunately, the baby....now 2 1/2 weeks old....has gained 1 ounce in
the past 5 days.   I took my great scale to the visit today and mom
transferred 1 ounce during the feed.....so she's supplementing with 1 oz
formula after....so that the baby gets 2 oz/feed 9x/day to = 18
ounces/24 hours (150cc/kg/day)  Can I get her milk up after severe
engorgement or is that permanent damage?  She is taking 2 fenugreeks and
2 blessed thistles 4x/day, feeding 15 minutes each breast every 2 1/2
hours during the day and 1 (4) hour stretch at night to equal 9 feeds or
4 1/2 hours breast stimulation.  Should she pump in addition to all that
stimulation?  when?  what else should we do?  Will a little tincture of
time make a difference or am I being unrealistically optimistic???
Thanks wise ones!!!!!
janna CPNP, IBCLC in w. htfd. CT

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