Sara wrote:   "I wondering if we need to re-look at our use of cold and
warmth??"

This is an interesting thread that is being revisited.  I enjoy the cultural
elements.

Well established practice here for "normal" engorgement on day 4 or so is
for the mother to take a warm shower before feeding.  Also, the use of cold
cabbage leaves between feeds is often used and well known by both mothers
and health care providers.  Mothers report enjoying the coldness.  Some
mothers will use a packet of frozen peas.

Instead of the shower, I prefer to try gentle expression to soften the
areola or to use Jean Cotterman's reverse pressure softening.  I do suggest
cabbage leaves, too.

For badly managed breastfeeding, often time-consuming hand massage will get
the milk flowing and baby can do the rest.  Electric breast pumps are in
short supply and I would be cautious in using one before getting the milk
flowing by other means.  Ibuprofen can be useful sometimes.

We also often use ultrasound therapy which is really effective for milk
stasis.  I am trying to encourage a therapist to write about this.

My 2ml worth

Jean Ridler  RN  RM  IBCLC  Cape Town, South Africa  [log in to unmask]

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