Debbie, Have the mom substitute ice for the warm water soaks. Sometimes when the breast is very full, the milk sinuses are compressed by edema and milk flow is impeded. Using ice will help reduce the interstitial edema and allow the milk to flow again. Mom might like to increase the number of pumpings as well to avoid engorgement in the first place. She might also do better with another type or brand of pump. Selection of pumps is an incredibly individual thing, in my experience. I have sent mothers to other depots for another brand of pump if the one I rent does not work well for them (rarely). Catherine Watson Genna, IBCLC