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Thread: Engorgement and No Milk/1 side

  1. #1
    Join Date
    Dec 2006
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    3

    Default Engorgement and No Milk/1 side

    Hello. I am so happy that I found this site. I can really really use some help. I just delivered my little girl on Christmas Day and was really happy to know I could breast feed! I had breast implants a few years back along with inverted nipple repair (didn't think about the consequence since I didn't plan for children). So when I saw things working I was thrilled! Here's my problem:

    I'm engorged...a lot. It's considerable, it's flaming hot and they are big. I just noticed it last night so it's only been 24 hours how. But I am able to express milk (with fingers and pump) from the left side. There's nothing at all from the right and that side hurts worse.

    The lactation consultant said to keep nursering her on the right first and it will just come. I am not so sure and she's fussy more frequently today like nursing isn't giving her what she needs so she's hungry right away after she's done.

    I just don't want to risk any infection or other troubles on the right side. I've heard hot pack, cold pack, pump it and/or leave it. I tried the hot pack with no results. Massage with no results. Pumping with no results.

    Anybody out there have any ideas. I'm miserable and just want what's best for my baby. Thanks!

    Tiffany

  2. #2
    Join Date
    Sep 2006
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    562

    Default Re: Engorgement and No Milk/1 side

    Welcome, Tiffany, and congratulations on your daughter's birth and on getting breastfeeding off to a good start!

    Here is a useful FAQ that covers the bases on engorgement, what to do, what to expect, what to watch for. Try the Reverse Pressure Softening if the engorgement is making it harder for your baby to latch on well:

    http://www.llli.org/FAQ/engorgement.html

    At four days postpartum, you are right on schedule for your milk to "come in" (i.e., the milk is changing from colustrum to suddenly greater quantities of mature milk). This sometimes results in engorgement, as you are experiencing.

    Engorgement is partly due to the sudden increase of milk, and partly due to tissues swelling in response to being filled up with milk. Sometimes engorgement is made worse by certain procedures during childbirth -- for example, a mother who received IV fluids as part of an epidural anasthesia may experience worse breast engorgement as all the extra fluid is getting worked back out of her system.

    Just as if you sprained an ankle and it swelled up, applying cold packs to engorged breasts can bring some relief. But the really important thing is just to keep nursing at least 8-12 times per 24 hours (more frequently is fine, too!). You have to move milk out of your breasts on a regular basis to relieve the pressure and to establish your milk supply. With normal engorgement, you should see improvement within another couple days, so just hang in there and wait for this to pass.

    The one part of your post that concerns me is this:

    But I am able to express milk (with fingers and pump) from the left side. There's nothing at all from the right and that side hurts worse.
    Before the engorgement started, did you ever see colostrum/milk come out of the right side? If so, how long ago did you find that you could not express any milk from that right breast?

    You mentioned in your post a history of breast implants and inverted nipple repair, and with that in mind, I just want to clarify the details a bit. As you knew already, a previous breast surgery can interfere with either milk production or the ducts that allow milk to come out of the breast. It's hard to know how things will go with breastfeeding until you try, and so I am thrilled along with you that things are working and you are breastfeeding!

    To make sure that things continue to "work" and that your baby is doing well, you should be keeping track of her diaper output and making sure she goes to breast at least 8-12 times per 24-hour-period (approximately every 2-3 hours, and more often is fine). For her diapers, by day 4 you should be seeing at least 4 wet diapers and 2-3 dirty diapers, with the stool well on its way to a yellowish color (no longer black or green from meconium, the first stool).

    Keep us posted, don't hesitate to ask questions, and hang in there! I know the engorgement is uncomfortable and stressful, but if you and your daughter keep nursing well and often, it should be much better very soon.

  3. #3
    Join Date
    Dec 2006
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    3

    Default Re: Engorgement and No Milk/1 side

    Thank you for the reply. I appreciate it so much!

    After I posted last night I tried to pump again to relieve some pressue to no avail. Nothing would come again from my right side and my left gave me about 4 drops and stopped. My nipples were engorged and hard at that point too. My biggest concern is Ava. I don't want her to go hungry. I'm so tempted to just give her formula. I'd keep breast feeding but just think maybe I need to supplement.

    The month before delivering I always had a white paste like on my nipples; both of them. Is that the way colostrum looks? It would wash away in the shower and come back again daily. In the hospital after delivering her I remember rolling my left nipple to harden it to get her to latch and was tickled to see a bit of yellowish substance come out...maybe "that" was really the colostrum? I could not get the right side to do that either.

    I had a great experience just now after feeding her. When she pulled off of my left side she actually had milk leaking from the corner of her mouth.

    Both breasts are very hard into the armpits. The lactation consultant told me they should feel softer after feeding. They don't. They are very hot to the touch.

    My question is this: if I cannot even hand express milk from the right side or pump it how can it be there? The lactation consultant said to not worry and always starts on the right. This morning when I tried that Ava was really frustrated, wouldn't latch and kept pulling back. She doesn't do that on the left.

    Any more advice is greatly appreciated. I think a home visit by someone who knows what to do would make me feel a lot better. Can I get someone out here? I was going to call the lactation consultant at the hospital again but thought I'd come here first.

    Sorry for the long post. Thanks again for the help. I truly appreciate the help being a "green" mom.

  4. #4
    Join Date
    Mar 2006
    Posts
    196

    Default Re: Engorgement and No Milk/1 side

    I just wanted to say congratulations on your breastfeeding success so far. I know it may not seem like success to you because you still have some things to work out. But take it day by day, get the help you need, come here for advice and support as much as you need to! The LLL leaders have so much wonderful information and tips that I would never have made it if it wasn't for the reassurance of them.

    The best advice I got was to monitor diaper output. And the face covered milk is definatly a good sign! Keep it up.

  5. #5
    Join Date
    Sep 2006
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    562

    Default Re: Engorgement and No Milk/1 side

    Quote Originally Posted by XmasMommy View Post
    Thank you for the reply. I appreciate it so much!
    You're very welcome!

    After I posted last night I tried to pump again to relieve some pressue to no avail. Nothing would come again from my right side and my left gave me about 4 drops and stopped. My nipples were engorged and hard at that point too. My biggest concern is Ava. I don't want her to go hungry. I'm so tempted to just give her formula. I'd keep breast feeding but just think maybe I need to supplement.
    Before you think about supplemental feeds, let's talk about Ava's diaper output. How many wet and dirty diapers has she had in the past 24 hours?

    There is often very little correlation between pumping output and milk transfer while nursing. Pumps are not babies, and all things being equal (assuming a healthy full-term newborn who is capable of nursing effectively), a baby will do a better job than a pump at removing milk from breasts. For starters, your letdown reflex is primed to respond to Ava's smell, touch, and suckling. A pump just isn't the same!

    The month before delivering I always had a white paste like on my nipples; both of them. Is that the way colostrum looks? It would wash away in the shower and come back again daily.
    Yes! Many mothers find that their breasts leak colostrum late in pregnancy. I remember finding whitish crusty stuff every day on my nipples during the last couple months. I suspect this is an excellent sign that both your breasts can lactate despite your breast surgeries.

    In the hospital after delivering her I remember rolling my left nipple to harden it to get her to latch and was tickled to see a bit of yellowish substance come out...maybe "that" was really the colostrum? I could not get the right side to do that either.

    I had a great experience just now after feeding her. When she pulled off of my left side she actually had milk leaking from the corner of her mouth.

    Both breasts are very hard into the armpits. The lactation consultant told me they should feel softer after feeding. They don't. They are very hot to the touch.
    That's the engorgement, including the part about the armpits and the hot-the-touch status. I hope by now things are starting to feel a bit better, but keep applying cold packs in between feedings and keep nursing frequently.

    My question is this: if I cannot even hand express milk from the right side or pump it how can it be there? The lactation consultant said to not worry and always starts on the right. This morning when I tried that Ava was really frustrated, wouldn't latch and kept pulling back. She doesn't do that on the left.
    From your description, it sounds as if all signals are go with your left breast. The right breast sounds less of a sure thing, but it is much too early to give up on it. It is possible that the engorgement is interfering with milk flow more noticeably on the right side. But engorgement will pass, and it is really important that you continue to nurse on that side to protect the milk supply and to give your daughter time to practice nursing on that side.

    If Ava's frustration at the right breast makes it impossible to stay latched and nurse well, you might try the Reverse Pressure Softening technique that is described in the link in my last post, to make latching easier. You could also try starting a feeding before she is ravenously hungry and desperate (it's often a very small window of opportunity with some babies, so just do your best).

    [/QUOTE]Any more advice is greatly appreciated. I think a home visit by someone who knows what to do would make me feel a lot better. Can I get someone out here? I was going to call the lactation consultant at the hospital again but thought I'd come here first.[/QUOTE]

    A home visit with an IBCLC or a LLL Leader is a wonderful idea! Some offer that service and some do not; it all depends on that person's individual circumstances. But it sure couldn't hurt to ask around. Call your local LLL Leader(s) and discuss the situation. There are many things an in-person helper can do for you that we simply can't do over the internet, including evaluate your latch on both breasts and observe Ava's behavior throughout a feeding.

    If the right breast continues to be an issue, again, don't panic or rush to conclude that it's hopeless. There are still a LOT of things to try first. I am hopeful that as the engorgement passes, you'll start to see better milk flow from that breast, so let's take this one day at a time for now. Again, be sure to track the diapers and count the feedings. Once things are established and Ava is back to her birth weight and clearly thriving on your milk, then you won't have to keep counting and clock-watching. This is just a short-term safeguard. Hang in there and keep us posted.

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