Oxytocin injections *might* help engorgement if the milk is able to be 
removed at exactly the time that the oxytocin is working. From my midwifery 
days I recall it takes 3 to 5 minutes to work from an IM injection, and 
then it's action is short-lived. You'd need to either have the baby on the 
breast, or the pump at the ready straight away. And as you pointed out - if 
there is areolar swelling then neither baby nor pump will get anything out, 
with or without oxytocin.

Frankly it doens't sound like a good treatment plan. I'd think that 
frequent feeding, hand expressing whenever uncomfortable, cold packs and 
RPS when needed is the way to go, and lots of reassurance so that the 
mother releases her own oxytocin naturally. This isn't a condition that 
usually responds to a once-off quick fix.

It was very heartening to hear the response from the nurses to your talk - 
let's hope that changes are beginning and soon no one will need to come to 
ER for this problem. Gosh, my heart goes out to those women - imagine the 
pain they must be in to leave home to go to an ER so soon after giving 
birth, with their new baby, because their breasts are so painful.
[Actully I don't have to imagine it - 24 years ago when I had my first very 
sleepy baby I got massively engorged and was treated with heat packs under 
a huge binder that took two people to remove when I needed to feed. No, it 
didn't help!]

Denise

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Denise Fisher
Health e-Learning
http://www.health-e-learning.com
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