Hi Laura,
My first thought is lots of fluid in her tissues, which could be
helped by reverse pressure softening, with mother lying on her back
with gravity assisting. Do the RPS for several minutes and each time
mother expresses or latches baby.
I presume she is supplementing baby? Is that correct? If baby will
latch, I would use a lactation aid so baby is at breast often and STS.
My other thought is, since this is an older primip, does she have any
intervening medical factors, namely PCOS, infertility, or even
pregnancy hypertension, etc? This could be having  an impact.
I'm ok with galactagogues, but my focus would be baby to breast. How
is she supplementing? Can she use cup or finger feeding, if not
lactation aid?
Laurie Wheeler RN MN IBCLC
Mississippi USA

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