Looking for insights:
 Currently working with a mom . Had breast implants ( under the muscle) in
2000 due to small breasts ( mom states equal in size and some rounding but
a AA Cup) Her first baby two years later was unsucessful  at
breastfeeding. Mom reported no breast changes , milk never came in and
gave up. Mom had noticed breastchanges this new pregnancy , delivered 1
week ago. 3 days PP had what sounds like engorgement. Today breasts are
still full upon exam . BAbe had lost 10% of birth weight per mom by day 3
of life. According to her weight info , babe is up 4 oz. today  BAbe does
have a very disorganized suckle at breast, will nurse for a minute or so
with well flanged lips then go to pursed mouth, shortly fall off, scream
and eagerly seek the breast again. This is a slightly strong willed baby (
first one I have seen in a while that screamed until he was purple when
mom was carrying him in the baby seat.)
 Anyway- so here I have a baby thats gaining but doesn't suckle well or
obviously swallow often. Mom states only one 1/2 supplement given since
birth. Babe also has had only 1 BM today but voids are clear. After
nursing at breast in what mom stated was a normal session, postweight
showed only a 5cc intake. Had mom double pump and recieved an active spray
for a few minutes that totaled 30 cc. During the pumping though ( lowest
setting) I noted moms nipples became very (VERY) dark, almost black
bruised looking. Mom denied any discomfort and nipples slowly returned to
their natural color.  Mom says she had never noticed this before. I was
thinking Reynards but never any blanch or pain. Then I thought about nerve
damage/decreased sensitivity due to implants but mom states her nipples
are very sensitive during foreplay and when babe is not latched well.
 So I guess it could sum up like this: screaming, frantic,gaining weight
baby with terrible suckle and rare swallows, decreased stool output, but
still voiding well.
 Dedicated mom with history of very small breasts, breast augmentation,
Perceived or actual insufficent milk supply with first baby and
significant darkening of nipples when pumping but NO PAIN and releasing
only about 35 cc on PPday 8.
  QuestionS: 1) antone ever seen a nipple reaction like this with
augmentation moms?
2) This kid acts like a starving Marvin - but the verbal and visual
accounts don't add up ( wonder if someone is sneaking the kid food?)
 I'm having mom nurse calmly and frequently, using breast massage before
feed to support letdown ( and hopefully help the babe). Dancers hold did
improve a little of the coordination and I have a follow up with them for
weight checks.
 Any other ideas or insights you all can think of?
Thanks

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