I am needing information on extended PP engorgement (beyond 48 hours) and its
role in being unable to fully maintain or up a supply beyond the baby turning
6mos to a year.

I've heard that severe, rock hard extended engorgement can cause the
prolactin receptors to communicate to the body that the baby died, thus the
inability to offer extended breastfeeding.

Case in point:
Mom who has great natural births at home; baby to breast immediately and
every 3 hours during colostrum; mature milk coming in at day 3; within 3-4
hours of mature milk coming in mom's cup size goes from a D to a J; this has
occurred with both of her children - each time worse; mom currently pregnant
and worried about extended nursing; possible gigantomastia during pregnancy
(going from an A to a D in 10 days at 14-16 wks gestation); currently rock
hard engorgement; veins popping out; painful tender breasts due to the
swelling; currently not nursing; prior births: nursed  thru a pregnancy (1st
baby was 6 mos when conceived the 2nd child); tandem nursed for 19 mos; when
older child weaned, milk supply drastically dwindled; while still nursing 2nd
child breasts had severe atrophy & supply decreased; both her mother and
grandmother experienced severe, rock hard  PP engorgement with their 4 and 5
children respectively - however - babies were only nursed for 15 mos by her
mother and 6 mos by her grandmother; mom does not experience let downs beyond
the first few weeks following birth; cannot leak; while engorged the breast
tissue is so incredibly swollen that a pump can not suction to the breast;
massage of the tissue is too painful & since mom does not leak - there is no
benefit.

I'm at a loss as to how to proceed with this mom.  Currently she is 21 wks
pregnant and her midwife is concerned about the gigantomastia - mom is more
concerned with the PP period of engorgement.

Any insight and places to research this unusual occurrence would be greatly
appreciated.

Cheri Cas, BS, Breastfeeding Advocate

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