Coach Smith here.

There is NO RESEARCH - repeat, NO RESEARCH supporting the use of heat on
engorged breasts, inflamed breasts, sore breasts, or any other condition of
the lactating breast!  NO RESEARCH. Yes, many books and articles and people
suggest using heat, without ANY research to back up that advice!  

The rationale given is that "heat is comforting." Yes, that's right - and
cold is also comforting. Both heat and cold will temporarily relieve pain by
triggering thermo-receptors in the body, until the body habituates in about
20 minutes.  That's why alternating heat and cold will relieve pain better
than heat alone or cold alone. Most evidence-based guidelines on use of cold
for therapeutic purposes specify 15-20 minutes ON, then 20 or more minutes
OFF the skin.  

Heat increases blood flow. Cold increases blood flow.  If increased blood
flow is what you want, then either will do, as long as no harm is done.

Here's the kicker: heat INCREASES swelling and edema. Cold REDUCES swelling
and edema. If there is swelling or edema present, DO NOT USE HEAT.  

If the breast is merely full of milk, remove milk by any effective and
comfortable means, preferably the baby. 

Why suggest or use thermal treatments in the first place? Find out what's
wrong, then use an appropriate remedy that does not do any further harm. 

Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre Ltd.
6540 Cedarview Ct, Dayton OH 45459 USA
(937) 438-9458 / fax (937) 438-3229
www.BFLRC.com 

-----Original Message-----
From: Diane Wiessinger [mailto:[log in to unmask]] 
Sent: Sunday, January 06, 2008 4:59 PM
Subject: adhesive thermal pads - don't!

Part two of "the worst mastitis of my career" is what *else* happened to
this poor mom's breast.  She had put an adhesive thermal wrap on the upper
half of her breast, and then put one on the lower half.  She thinks perhaps
that second pad pulled the first pad too tight; apparently there are
cautions on the package about putting them on too tightly.  And of course
she was using it on swollen skin, which is also not recommended.  She woke
up in the night with second degree burns on the upper part of her breast,
thankfully away from where baby mouths and pump flanges go.  They're
substantial burns, no doubt surrounded by first degree burns that probably
contribute to the overall redness of her breast.

But having seen her breast, I would never recommend that a mother use a
thermal wrap as a heat source on a breast!  Scary indeed!

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com

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