THis is a situation posed by a colleague here in NY: 32yo primip, from India called prenatally concerned about avoiding mastitis and abcesses experienced by her mother and grandmother. Full term baby girl born by c-section, started to refuse breast on day 3, having been content at breast before this. Breasts engorged, tender to touch, normal in appearance. Palpated dense tissue under large areolas bilaterally. Mom has practiced BSE and stated that this condition is new. Cannot feel lactiferous sinuses at all. Massage and manual expression yielded only drops, mother d/c efforts due to tenderness. Repeated bilateral pumping with Lactina for 45 mins on low, then medium yielded 1, 2, and 1 teaspoons on three occasions. Baby now being maintained on abm and whatever milk mom expresses. Has anyone seen such dense tissue that milk expression has been so difficult, and if so, what helped? Thanks, Margot Mann via Catherine Watson Genna, IBCLC NYC [log in to unmask]