Lynn,
Actually, I have not seen severe engorgement persist >24 hours very often.
And yes, the flow does usually gradually improve, but sometimes it seems
agonizingly slow.  If my memory serves me right, these have mostly been cases
where mom has edema otherwise and/or has not been breastfeeding consistently
or well for a time leading to the exacerbation of engorgement.

I wanted to make the point that we shouldn't assume the baby can or will do
better than an effective pump.  Most of the time when moms call with trouble
due to engorgement it seems the reverse is true.  They call because the baby
can't manage until the pump or hand expression or massage or something to
reduce swelling or fullness was done first.  If this is not the case and I
cannot verify effective breastfeeding by the time we are done working
together, I am not comfortable leaving them without some kind of plan to keep
baby fed adequately and mom getting adequate breast stimulation & tx to get
better.

Natalie Shenk, BS, IBCLC; Findlay Ohio USA; [log in to unmask]

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