You know what? I think we need a definition of engorgement.  If Pamela sees
'a lot' of it in a place where there is rooming in and ad lib feeding, and
we see hardly any, then something's up with our definitions.

I think we're seeing the same things.

But here, it is not 'treated' except by ensuring the baby is feeding well,
and gentle hand expression to comfort (occasionally in severe cases a
mother may pump once or twice - but this is rare).

I honestly can't remember the last time I heard directly or indirectly of a
mother in long-lasting great distress or discomfort from engorgement - and
it used to be very common.  They may have a bit of an uncomfortable day or
so, if the baby's needs and her production are a day out of sync - milk
comes in day 2-3, baby still quite sleepy and still learning about feeding
until day 3-4.  The fullness may last a lot longer, but if the baby's okay,
and she's okay and the feeding is going well, there would normally be no
suggestion to do anything else but hand express when needed (small
amounts). We wouldn't call it engorgement.

To me, engorgement is very uncomfortable/painful hard, lumpy, swollen
breasts which are not relieved much, if at all, by the baby feeding.

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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