I have been asked by two of the LC's that I work with to please post this case and see if anyone has heard of anything like this. A gravida 3 now para 3 , 4 days postpartum was seen today in our outpatient clinic for severe engorgement. She told the LC that this happened with her other babies and she was never able to breastfeed. The LC said her breasts were enormous and hard and even with hot packs and massage and breast pump...not a drop. Then she noticed that the women's nipples were like the bottom of someone's feet...kind of rough and calloused (sp?) looking. The patient reported that for as long as she could remember they have always been like that. As the heat and massage progressed, the LC noted that milk began leaking out of everyone of her montgomery glands...every single one!! She was never able to get a drop out of the nipple. The patient had told her doctor about this problem during her pregnancy and did not get a referral to have her breasts evaluated. She started to cry and told the LC that this was the first time anyone had ever really listened to her. The plan now is to use cabbage leaves for the engorgement and to get her in to see the OB tomorrow..I do not think the OB is going to be very helpful. We were thinking perhaps dermatology? perhaps even a breast surgeon to evaluate the breasts. It really is too bad that we did not get a chance to help this lady before her baby was born. The baby has latched on to the breast pretty well before the engorgement got so bad but the LC did not think the baby was able to draw anything out of those nipples. Any ideas out there? You can post to Lactnet or email me privately if you wish...this one really stumped the two LC's in our hospital. It would be really great if we kind find a solution to this problem...this mother desperately wants to breastfeed this baby. TIA Donna [log in to unmask]