From a colleague not on Lactnet. Any thoughts?
 <<I had a mom come in with sore nipples and poor let down to the pump. She is getting ready to go back to work and trying to pump some milk now. She told me her nipples looked bruised and this was my observation. While she was nursing, her other nipple began leaking. The upper part of the tip of her non nursing nipple became blue. When the baby came off the breast her nursing nipple also looked blue. Both nipples looked the same, even though one was nursing and one leaking. When she began pumping she could get only small drops of milk (maybe 5 cc). And again the upper half of her nipples were blue. I guessed this was a circulatory issue. A vaso dilation. So I gave her gel pads(cool) and asked her to let me know if the cooling of the nipples helped increase the flow. We also discussed hand expression and she got a little more milk, but I think her ducts are swollen at the pores from this vaso dilation. Have you ever seen this? and do you have any suggestions for me to give. Thanks>>  Warmly,
Pat Bucknell IBCLC
Avon Lake OH (far west suburb of Cleveland along Lake Erie)

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