I do not recall that this mom has large nipples--only that they are 
flat. If that is correct, then I would not assume the baby needs to 
grow at all to latch, but the baby may well need CST to be able to 
latch. Cesarean birth is inhernetly a risk for structural damage and 
the reasons (real or created) for the cesarean can also be a cause of 
structural trauma. In such a case, I would do two things--asses abbay's 
ability to feed (as opposed to mom's breasts being the problem) and 
refer if needed and I would suggest the mom take milk thistle and 
dandelion leaf to rapidly allviate the edema. While milk thistle is 
also considerd a galactogogue, this is in relation to its ability to 
support liver function. Dendelion support kidney and liver function. 
Frankly, I'd love to see very mother who has had drugs do liver support 
after birth so that she can support the liver after the stress of 
pregnanacy and then drugs on top of it.

Jennifer Tow, IBCLC, CT, USA

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