I wrote an article on engorgement?for Breastfeeding Abstracts (November 2000, Vol 20(2), p11-12. In my research at that time I came across a couple of unpublished master and doctoral theses that looked at using heat or cold therapy:

"Some mothers complain that heat exacerbates the engorgement, causes throbbing and an increased feeling of fullness. Robson discusses that application of cold for 20 minutes would have a minimal vasoconstriction effect in the deeper breast tissues? and that venous and lymphatic drainage would be enhanced in the deeper tissues due to the accelerated circulation to and from the superficial tissues."

Robson BA. Breast engorgement in breastfeeding mothers. Doctoral dissertation, Case Western Reserve University, Cleveland, Ohio, 1990. UMI order #PUZ9023094

"Sandberg reports on the application of cold packs for 20 minutes before each feeding on a small sample of women. Mothers reported increased comfort compared to heat, decreased chest circumference, and no adverse affect on milk ejection or milk transfer."

Sandberg CA. Cold therapy for breast engorgement in new mothers who are breastfeeding. Masters thesis, College of St Catherine, St. Paul, MN, 1998

Also found were these descriptions of what happens when cold is applied to tissues:

"Cold application triggers a cycle of vasoconstriction during the first 9-16 minutes where blood flow is reduced, local edema decreases, and lymphatic drainage is enhanced."

Hocutt JE, et al. Cryotherapy in ankle sprains. Am J Sports Med 1982; 10:317-319

"This is followed by a deep tissue vasodilation phase lasting 4 to 6 minutes that prevents thermal injury."

Barnes L. Cryotherapy: putting injury on ice. The physician and sports medicine. 1979; 7:130-136

In the Breastfeeding Atlas 1999, Barbara Wilson-Clay reported the relief of discomfort and better subsequent milk yields during pumping following manual lymphatic drainage therapy in 3 women with unrelieved severe engorgement.

It is always interesting to see how little studied this phase of lactation is.

Marsha Walker, RN, IBCLC
Weston, MA





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