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Had a pre-term baby by C-section. Breasts feel heavy and leaking milk. Facing trouble while breast feeding

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I had a pre-term baby by C-section at 32.5 weeks of pregnancy on 29th March due to water leak. Everything was close to normal during my pregnancy. She was admitted to NICU immediately and is currently being given feeds through tube. I have started expressing milk so whatever I can express is given to her and the remaining is fulfilled through pre-nan.
I am facing a lot of difficulty while expressing my milk.
1. My left breast feels heavy but milk expression from it is very slow and painful. Before my discharge after c-section, nurse tried to express milk from the same by pressing really hard, is it possible that my left breast has sufferred any XXXXXXX damage?
2. My nipples have gone very sore because of continuous use of breast pump. They have started bleeding a bit since today morning, so expression by pump is no longer possible.
3. While expressing by hand too, my left breast pains a lot more than my right breast and very little milk comes out of left breast though it feels heavy.
4. My breasts keep leaking milk but while expressing the amount of milk that comes out at one attempt of one-hour long is comparatively very less... between 20-50 ml. Why do my breasts leak milk when expression is low? Are they not capable of holding milk in them?
I have started expressing since 1st April.
Please suggest what I can do.
Posted Sun, 28 Apr 2013 in Women's Health
Answered by Dr. Timothy Raichle 25 hours later
Hello, I would be happy to help you with your question.

I am sorry that you are having so much trouble with breast-feeding. This sounds very difficult. I am assuming, also, that your child is doing well in the NICU.

From what you are describing, it sounds like you have made very aggressive attempts at breast-feeding, and that these attempts have led to some skin breakdown that has made these efforts even more difficult. As far as things you might try moving forward:
1. Warm compresses on the breasts 15 minutes before feeding (but make sure that the skin does not get wet as this will lead to further skin breakdown)
2. After pumping or expressing, you need to air dry the nipples for at least 15 minutes
3. If at all possible, you need to get back to breast-pumping. I know that you say that this is out of the question, but the sucking action is most similar to a baby feeding and is the best way to keep your milk production up.

As far as answers to your questions:
1. No I do not think that there has been any XXXXXXX damage to the breasts
2. I think that 'expressing' the breasts is not as effective as the sucking action of the pump. That is why they seem to 'leak'. They still need to be emptied. Hopefully you have a good pump so that you can spend less time pumping and more time letting the skin heal
3. You might be developing an infection of the left breast. This needs to be assessed by someone - especially if the skin is appearing red or tender.

If at all possible, a visit with a nurse specializing in lactation would be ideal. I hope that this helps. Please ask if you have any followup questions.
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