Cheryl writes about a mom with one-sided engorgement after using
fenugreek.  I wonder if the question isn't "Why is the right side
engorged?" but rather "Why isn't the left side equally involved?"
Since she has had problems with supply for some time, she MAY be one
of the rare moms with insufficient glandular tissue, but only on one
side.  Perhaps there was so much emphasis on getting equal treatment
to both sides, that the right didn't get enough stimulation to
really "kick in".  The right may have respondid to the fenugreek and
perhaps the left is incapable of response.  If I were seeing her, I
would probably suggest trying More Milk.  I would also tell her that
while it certainly is more practical to nurse on 2 sides, it is
possible to fully nourish a child only nursing on one side.  Mom
will probably have to tuck a few extra bra pads on the other to
"look even".  I think what's so often behind mom's concerns in a
case like this is her fear that it's both or nothing.  I rarely find
a mom who does wind up nursing only one side, but the knowledge that
it is possible goes a long way to help her relax about it and
concentrate on what the infant is doing well, not what she wishes
baby was doing differently.
I would question the wisdom of using hot packs.  If what she is
experiencing is delayed initial-type engorgement, then according to
all the recent studies I have read about, cold would be the Rx of
choice.  Especially if it takes 2 hours of warmth before baby can
latch.
There may well be other factors, but these are the thoughts that
came to my mind on first reading the story.  Hopefully there will be
other suggestions and you can go about the detective work of
figuring out which applies to THIS mom.
Winnie Mading, RNC, IBCLC

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