I worked with a  mother G8, P6, L1, first child only. Mother states she could not latch any child after the first baby and could not express any milk when she tried to express, the breasts got engorged and a couple of times got a breast infection. She reports that her nipples became thick in her second pregnancy. When I saw her, infant was 4 days old, she has large, round breast, lots of glandular tissue, her nipples were thick and infant was unable to latch. I was able to see some milk coming out when I did breast exam/areola compression. I recommended to massage breasts and express every 2-3 hours and asked her to stop if breast were getting hard and red. At the f/u apt, she stated that she was able to express 20mls each time and that she got more engorged and that her breast got red and hard and painful. 
She asked her mom this week about her bf experience, mom  told her  that she had the same situation . This mom had other sisters who bf well. The question to you is: if there is a name when nipples change so much in pregnancy, and, is it possible that the change in the nipple structure could have"blinded" or close multiple pores and ducts?

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