Coach Smith here again. Yes, there's an outlet for milk in the breast. But not for edema in the breast nor edema in an injured ankle. Engorgement is edema PLUS milk stasis. Two different processes. In the breast, edema is most likely to happen in the early days postpartum, when the whole physiology of lactation triggers profound changes in circulation, milk synthesis, fluid dynamics, etc in the breast tissues. BTW, edema happens in cows, too, especially first-time mothers. It's almost as if all the extra fluid that collected around the mom's ankles during pregnancy goes running up to the breast to see what's going on. [Thanks to Martha Grodrian (Brower] for that analogy). Edema is generally easy to recognize and short in duration. AFTER the initial edema response is passed, warmth can facilitate circulation or healing. Milk stasis is another thing. Milk stasis left unrelieved can result in edema. Great early breastfeeding management, as we're hearing from our colleagues in England, eliminates much of the milk stasis and therefore much of the edema. Simple milk stasis (without edema) is usually relieved by ordinary mechanical methods - baby nursing and/or pumping. Thermal applications are probably unnecessary in either case. If heat or cold appear to help, I agree with Jan - let's officially study this in a situation of simple milk stasis without edema. I bet we won't find any difference between heat vs. cold, or thermal treatments vs Scotch vs. a backrub. But back to edema. Heat makes edema worse, which will automatically make milk stasis worse. Before recommending a thermal treatment for full breasts, decide whether you're dealing with milk stasis, or milk stasis PLUS edema. I maintain my position: don't put heat on edema in the breast or elsewhere in the body. Linda J. Smith, BSE, FACCE, IBCLC Bright Future Lactation Resource Centre Dayton, OH USA http://www.bflrc.com