I received this from my client.  Thanks to everyone who emailed with
suggestions.  I'm waiting to hear from the baby's next weight check.  

eureka! we have success.  the combination of rps, the larger size (27mm)
breastshield, and pumping for less than a minute  before feeding and we have
much improved flow and we're not using the nipple shield!  I have 'spray'
now- I had it right away after trying the bigger flange size.  I have noted
that trying to skip the rps doesn't work; she can't latch well unless I do
it and gets fussy.  I'm drinking grapefruit juice, eating parsley and I
think it's helping - my whole body is less swollen.  I'm pumping each breast
after she feeds, but not every time.  She seems satisfied with how things
are going.

these articles really helped explain all this.  i've learned a lot - maybe
would have made some different choices about my baby's birth, but that's
history and i feel confident this will be worked out in a week or so.  We're
really grateful  for your help and encouragement and for helping me stick it
out - it will all be worth it in the long run.  I hope some other
'edematous' woman benefits from this experience if you ever come across it
again - as I told you, I had really bad edema throughout my pregnancy,
before the pitocin and other drips.
many, many thanks again- 

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