Dear Friends:
    I am caring for a mother who has chosen to pump and bottle-feed.
    She had no difficulty conceiving, and has a history of fibrocystic breast
disease. Over the past few weeks her milk volume has started to increase. (It
was low at first, in part from too-small flanges! She's a 27mm size.) She is
now one feeding ahead of her baby.
    Now, at one month post-partum, she has been going through spells of
painful breast lumps in each breast. This started about 10 days ago. Breast massage
6-7 times a day, use of green cabbage over the troublesome areas, and making
sure she isn't pressing the edge of the flange into her breast have all helped
some, but not completely. She continues to pump and increase her milk volume.
Nothing unusual comes out of her breast when she massages.
    She will see her physician on Friday.
    Does anyone have experience with a situation such as this? Any
suggestions?
    warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
Support the WHO Code and the Mother-Friendly Childbirth Initiative

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