I am stumped...I have a mom who is 12 weeks postpartum,  been working with
her for low milk supply for about 4 weeks.  Breastfeeding technique is fine,
no schedules, but she is back to work,  pumping q4 at work and bfdg at home.
With fennugreek is getting 4 oz total and needing to supp with formula after
most bfdg.  This is livable although not ideal for her.  New situation is
this. She comes to me today with episode yesterday of waking with Right side
only very engorged.  Did go to bed for first time without bra but otherwise
no changes...has been using fennugreed for at least 3 weeks.  Engorgement was
very severe and painful per mom...denies redness, warmth, fever, just lots of
swelling and pain.   Unable to pump with good electric pump...so she used hot
packs for about 2 hours then was able to get baby to latch and feed well.
Again right sided only.  Now she can feel a plugged duct on right side.
Confounding all this is she has a supernumery nipple vs montgomery gland vs
nipple pore directly under right aerola which is painful.  No leakage from
this site.  Oh and she got depo today---Ahhhhhh!

So what is this engorgement.  1-persistant plugged ducts?   I am trying to
arrange ultrasound for this   2- what is causing this unilateral temporary
engorgement.  this has happened 3 times since delivery   3-ok to begin
reglan, more milk tincture...etc to fight ongoing low supply??  do I look at
prolactin levels?

I am quite stumped.  Please email me personally and to the list so we might
all learn, yet I can find answers quickly to get to her!
Thanks so much

Cheryl Parrott RN, BSN,
Kokomo IN
Mom to Lexie 2 yrs old and Rachel-angel baby

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