Thanks Jean, for some wonderful explanations.  I really like the one about
the different size balloons.  I would like to use this in the future.
I will keep in mind your reverse pressure technique for the mother
experiencing the primary engorgement, especially around the areola.
What I recommend is that all LC's and others who work with the postpartum
woman get very comfortable with feeling the breast and noting when the milk
production is increasing.  I describe it to the moms and have them feel it
themselves.  Waiting for engorgement is too late and sometimes too difficult
when trying to explain the mature milk is "in".
Ann Perry RN IBCLC
Boston, MA

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