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Subject:
From:
Donna Cordoba <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 15 Aug 1996 23:59:36 -0400
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I have been asked by two of the LC's that I work with to please post this
case and see if anyone has heard of anything like this.

A gravida 3 now para 3 ,  4 days postpartum was seen today in our outpatient
clinic for severe engorgement.  She told the LC that this happened with her
other babies and she was never able to breastfeed.  The LC said her breasts
were enormous and hard and even with hot packs and massage and breast
pump...not a drop.  Then she noticed that the women's nipples were like the
bottom of someone's feet...kind of rough and calloused (sp?) looking.  The
patient reported that for as long as she could remember they have always been
like that.  As the heat and massage progressed, the LC noted that milk began
leaking out of everyone of her montgomery glands...every single one!!  She
was never able to get a drop out of the nipple.  The patient had told her
doctor about this problem during her pregnancy and did not get a referral to
have her breasts evaluated.  She started to cry and told the LC  that this
was the first time anyone had ever really listened to her.
The plan now is to use cabbage leaves for the engorgement and to get her in
to see the OB tomorrow..I do not think the OB is going to be very helpful.
 We were thinking perhaps dermatology?  perhaps even a breast surgeon to
evaluate the breasts.  It really is too bad that we did not get a chance to
help this lady before her baby was born.  The baby has latched on to the
breast pretty well before the engorgement got so bad but the LC did not think
the baby was able to draw anything out of those nipples.  Any ideas out
there?

You can post to Lactnet or email me privately if you wish...this one really
stumped the two LC's in our hospital.  It would be really great if we kind
find a solution to this  problem...this mother desperately wants to
breastfeed this baby.

TIA

Donna
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