On Wed, 14 Apr 2004 20:59:08 -0700, markha5 <[log in to unmask]> wrote:
"Baby is 6 weeks old. Mom had severely engorged breasts and pain
(itching, burning, stabbing). She stated she could not get the milk out of
the L. breast, but that the Baby did fine on the right. We tried manually
expressing and using a hand and electric pump. The L. breast only had milk
dribble out of one opening. Dad of the baby says it has always been this
way."
I am confused. Has she been THIS engorged the *entire* time, all six weeks,
or is this a reoccurence or an aggravation of the original engorgemnet?
There is NO milk coming out of the breast, or is the flow simply less than
the right? (a common occurence.) I would think 6 full weeks of serious
engorgement, with NO relief and no milk output would result in involution,
and actual engorgement would not be a problem anymore. If she is
still "engorged" there must still be milk flowing IMO. Did you witness NO
swallowing, and no ejection on your consultation on this breast? What does
the baby do if and when this happens? I can't imagine, if there is NO milk
being transfered he would be too happy to stay at this breast.
"After 3 days of this treatment she still could express no more milk and
only one duct opened"
How could that be known? I am still confused, there are structures in the
breast, but I don't know of how one could know specifically "one duct
opened." Did she get relief? I am assuming she got partial relief and the
parents assumed "one duct opened." Did you palpitate to see how the
structures felt after this report of "one duct opening?" (I have felt what
may be ducts "opening" and emptying during compression during BF, but I
could never be sure or even assume it was ONLY one.)
Have you tried good reverse pressure softening of the areola? I find this
tecnique to be invaluable for most types of engorgement. Is she so engorged
that the baby simply can't get a hold of the breast properly? This could
certainly impact draining. RPS is a good was to facilitate drainage, and
get that milk flowing. Does she have swollen areolas, too? RPS is probably
a good place to start, as well as really investigating the reports of "No
milk" being produced.
Mary Jozwiak IBCLC, RLC, LLLL, AAPL
Private Practice
>
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