I'm wondering Karen Foard, IBCLC wrote:
> Primip, no hx of infertility or problems during pregnancy, delivers 8#5 girl
 Tuesday, May
> 14.  ...On Friday, May 17,  at routine ped check, baby is 7#2,...
> Wednesday, May 22, 8 days old, however, on Monday, after hearing that she had
> again passed two large clots, and had throbbing twingy heaviness feeling and
> pain in her uterus, ...  When I saw the baby on Wednesday, she exhibited wonderful
> behavior at the breast, with definitely improved swallowing with starter tube
> feeder in place.  Breast examination shows:  Less than an A cup breast
> fullness, however, both parents said that this was an enlargement from prior
> to pregnancy and had noticed changes and tenderness at the start of the
> pregnancy.  One great nipple, the other misshapen, with inversion that was
> starting to pull out due to nursing and pumping. Upon exam and expression,
> milky fluid (drops) could be expressed from each nipple, no feeling of any
> glandular enlargement, no firmness or fullness at all.
>
> What would you do now?  Nipple stimulation is there (she has been using a
> good pump for extra stim) and baby is doing her job. How else can you rule
> out or prove retained placental fragment? Blood work- what levels would we be
> looking at ? Would this mom's baseline mammogram show basic glandular
> development to "see" if we are working with the rare  insufficient glandular
> tissue here?
> Suggestions?
> Karen Foard