I hope there are a few of you left (ie. haven't gone to the ILCA conference)
because I am totally stumped on this one!!!
Mom is now 3 weeks post partum. I saw her initially at 3 days for severe
engorgement. I was able to get the breasts soft enough to for her to pump
about 6 ounces with a double pump set up. The milk however had big clot-like
lumps in it. One was larger than a quarter.  I assumed they were plugs
related to the severe engorgement.  I have seen her several times since and
she is still getting milk clots but now they are from one breast only. (the
right side)
The "clots" look almost slimy and are evenly distrubuted though the milk. If
you move the milk around (not a heavy shake- but turning the bottle to look
at the clots) they break up and seem to disappear. If I don't move the milk--
the clots remain.  They do not re-appear in stored milk. No debris floating
on top of the stored milk, just what appears to be the normal cream layer.
The breast is so painful that she is unable to nurse on that side and has
been pumping on that side every 2 hours during the day and every 3 at night.
 There is one area of the breast that is reddened, and seems swollen just
above the areola on the lower, innder quadrent of the breast. The swelling
extends under the areola and into the nipple. So the areola is semi-swollen
on one side.  No obvious plugs at the nipple tip. No fever or signs of
mastitis.  There is no significant medical history or a history of breast
injury.
I decided to start her on lecithin and a low fat diet today--following Ruth
Lawrence's suggestions for repeated plugging. But I am not sure what I'm
looking at- could this be a sign of a severe problem or one of those odd
things we see that ends up being normal??
Help me if you have any information
Marie Davis, RN, CLC