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Thread: Strange problem: breast congestion?

  1. #1
    Join Date
    Aug 2012
    Posts
    110

    Default Strange problem: breast congestion?

    Hello everyone!

    This is my first post

    I have a daughter who will be 3 in a couple weeks, and an almost 6-week-old girl as well. I have a strange problem that no one seems to know what to do with except struggle through it each time - which is fine, and I will keep doing it because we hope to have more kids! But if anyone has had this happen, or has any new suggestions, I'm all ears!

    My breasts are quite different from each other - the left one has a flat nipple that both girls have been able to draw out within a few weeks of birth (before that it's all pumping and trying with the nipple shield). The right one makes more milk than the left, but I call it my "bad side" because not only does it have an inverted nipple that can't be drawn out of the areola (it adheres to the sides), but the breast seems to get, for lack of a better word, "congested." As if the milk gets stuck in there when they try to nurse. As a result, this side is more prone to mastitis, and almost every time I have had mastitis it has been in this bad side. It is easy enough to pump the milk out, though - it's just that my little ones will (after a few weeks of trouble due to the nipple shape, I assume) latch on to it fine, and suck and suck, and the milk doesn't come out for them, even if I pump a bit first or do compressions and even when I feel let-downs. It was similar with my first girl - I was able to stop pumping when she was 7 weeks old, but she had to use a nipple shield on the bad side until almost 3 months old. And even when she was finally exclusively nursing, I noticed that she would have to suck and suck a bunch of times before she swallowed on the bad side, whereas she could swallow with each suck on the good side.

    So I guess I'm just wondering if anyone has any suggestions. I feel like I've tried everything, but I'm sure there are more ideas out there! Do you think the bad nipple is the problem, as it makes the breast a different shape for them to latch on to, or might there be something else going on structurally on the inside, very few working ducts or something like that? I've considered for next time, just being a one-sided nurser from the start and letting the bad side dry up (carefully, so as not to get mastitis again!) - when we had such problems with our first, we were referred to a breastfeeding specialist doctor who took one look and feel of the bad side and said, "You might have to be a one-sided nurser." So I know that would be possible too, especially if I did it from the start. Right now I'm using an SNS to feed her the pumped milk, as we started with bottles but I felt that her suck on me (on the good side) was getting worse, as if she thought I was a bottle and wanted to be lazy!

    In the end I nursed my older daughter for over 2 years, and it was so worth it, so I'll never consider giving up, even if this is just how it goes for me every time. Just looking for any more ideas that people might have.

    Thanks!

  2. #2

    Default Re: Strange problem: breast congestion?

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    Karen
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  3. #3
    Join Date
    Jun 2009
    Posts
    5,750

    Default Re: Strange problem: breast congestion?

    So i take it this is not congestion related to engorgement? I had that, I always have oversupply, but its never led to any issues for me before, but with my last baby, now a month old, one side leaked and the other did not, so i got massively engorged the first week on the non-leaky side, but in my case neither baby nor pump could extract the milk effectively-not even the hosp grade pump. So while that side was easily twice the side of the other, i could only pump maybe one ounce to the smaller breasts three. After mastitis and discovery of massive plug, I 1) treated mastitis with anti-biotics 2) broke up the plug with a personal massager 3) saw two LCs to work on improving latch on that side, and 3) nursed baby very, very frequently, even setting my alarm overnight so we never went longer than two hours. (baby got plenty/was growing great so did not need to nurse that often, but I needed her too-she was slightly better at extracting the milk than the pump even with the massive engorgement.

    But in your case, what I found odd id that you can pump more milk from that that breast than baby gets when nursing. That is unusual, assuming baby has normal sucking skills. first i wonder, How do you know how much baby can extract?

    If baby truly cannot extract milk, and it’s not related to baby being unable to latch well due to engorgement, and baby has normal sucking skills, and the pump can extract milk-then that suggests some interior physiological issue. Have you seen an ibclc-someone REALLY well trained and experienced? What about some kind if internal imaging of your breast-maybe, if you can arrange it, WHILE pumping or while nursing?

  4. #4
    Join Date
    Aug 2012
    Posts
    110

    Default Re: Strange problem: breast congestion?

    Hi! Thanks for the great answer, lllmeg. I don't really know how much baby can extract from the bad side - it's just that she would suck and suck and not swallow, and eventually get frustrated and give up on it. So I'd then pump that side while she nursed the "good" side happily, and I'd get all this milk that she apparently hadn't been able to get out.

    The breastfeeding doctor I saw with my first daughter was an IBCLC - the one who said I might have to just be a one-sided nurser, but in the end she helped me get it all worked out with DD1. I've also seen a number of different breastfeeding counsellors, midwives, nurses etc. I had thought of the idea of internal breast imaging to see what was going on, but I have no idea how I'd go about asking for something like that - do you know?

    In any case, I'm not totally convinced we're totally done pumping, but DD2 hasn't needed any of the pumped milk from the bad side (via tube) for about 24 hours now - she actually managed to nurse from the bad side twice today, and I haven't pumped for 12 hrs and am not engorged! And I could tell she was finally getting milk - her chin had the little swallow pause, and the breast was actually softer when she was done. She looked so surprised when it started flowing, haha! I'll keep going like this as long as it works and as long as she's still gaining weight (we had trouble with that at first and she didn't regain her birthweight until 4 wks or so).

    So maybe it's just that they have to get stronger before they can suck hard enough to get it out of that side. This is really close to the age when my older daughter could do it, too - 6 or 7 weeks. But I might look into breast imaging between pregnancies here so that I can find out if there's anything wrong in there that could be improved to avoid all this.

    Thanks again!

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