Yes, I know - we all are treating engorgement with cool/cold compresses or cabbage leaves. But - one of the nurses in the support group at the Navy Base here asked me if I had any references that proved that cold/cool and not hot is better? Well, I've looked in my own archives of Lactnet (I save things under "breast" or "disease" if I think I'll be needing it) and in my JHL's back until ... well, to the beginning (didn't realize how small the print was on the indexes of some of those earlier JHL's - getting older!). Couldn't find a reference. She said she'd asked this question at a class she had taken and was told "well, everyone _knows_ this..." I found the Comparison of chilled cabbage leaves and chilled coldpacks (JHL II(1)95) and Chilled and room temperature cabbage leaves (JHL II(3)95) - but no comparison between warmth and cold as a relief of pain of engorgement. I assume as we understand engorgement to be swollen tissue and we use cold for swollen tissue there is good evidence to use cold - but where...? She may want to do her own study... Jeanette Panchula, BA-SW, RN, IBCLC, LLLL Puerto Rico [log in to unmask]