Unless I'm missing something here it sounds like lactogenesis was delayed and that now she is engorged. You mentioned that her areolas were puffy. I wonder if her ankles and fingers were swollen, as well. While moms are edematous the milk is often delayed. I also wonder if she has been spending a lot of time on the pump when nothing was coming. That can cause more edema. I'd get her on her back with ice packs all over her breasts as often as she needs them for comfort and to help reduce edema so she can get milk flowing. If she gets on the pump and nothing is happening within 2-3 minutes I'd suggest that she stop pumping, ice again and take ibuprofen. About 30 minutes later try pumping again. Try reverse pressure softening to soften areolas so baby can get a better latch. Avoid heat. Hope something helps soon. Anne Grider, IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html