Dear Elien, Naomi, Pamela and all:

This discussion has been collegial and professional.

I am remembering the original definition of "evidence-based medicine" ; my
source is the folks at Johns Hopkins. Evidence based medicine is a blend of
research findings, clinician experience and patient concerns and values.

I had my own personal clinical experience dismissed by one of the authors
of the new protocol.

I had an area of clogged ducts, created when my baby's little hand rested
on my breast for a long time. I woke up with a tiny red handprint on the
lower aspect of my breast that was "shotty", full of tiny little plugs like
grains of sand and then developed a fever.  I treated it with homeopathic
Phytolacca 30C. and a piece of cabbage leaf over the reddened area, and
massage in the shower.  I did not like the massage and didn't do it much.
I see now that I was doing it too hard, and hurting myself. (I now use the
word "petting"  instead of 'massage' when teaching about this.)

The cabbage leaf cleared and softened the area overnight. Long ago,
I learned that milk stasis led to milk proteins being reabsorbed into the
breast parenchyma, and that made sense to me.

I have learned, and consequently told patients, that they had made cheese
in their breasts, as milk stasis led to the milk solids settling out and
forming plugs.

To be told that it was all inflammation, that the shotty area was just a
place of narrowed ducts, and that my analysis was wrong was not helpful.

But in truth, all these thoughts are speculation. No one really knows what
is going on inside. We can't see. Like the parable of the 6 blind men and
the elephant, we are all probably right in our own way.

I have seen photographs of thickened milk that is released from a breast
when the "plug" moves down the duct and out.  Nancy Mohrbacher has one in
her great book, Breastfeeding Answers, 2nd edition. We've all probably
worked with blebs, when the "plug" gets stuck in the nnipple pore.

Maya Bolman's clinical experience adds much to this discussion, with ways
of healing that are effective, and freely accessible.

I do love the idea of avoiding antibiotics whenever possible. I see folks,
encouraged by the photographs of freezers full of neatly arranged bags of
milk on social media, pumping much more milk than they need for their baby.
I wonder if this excessive pumping is a fashionable trend, or a reaction by
a distraught mother, torn from her baby far too soon by a lack of paid
maternity leave, to somehow compensate.  Maybe we can call this particular
situation "induced hyperlactation?"

Our discussion here is so valuable, as we share our experiences, ideas and
thoughts. I am grateful.

warmly,

-- 
Nikki Lee, she/her/hers
RN, BSN, Mother of 2, MS, Grandmother of 1, IBCLC, CCE, CIMI, ANLC, RYT500
*@NikkiLeeHealth*
www.nikkileehealth.com

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