Actually, my dear friends, I think that getting rid of the engorgement itselfs will pretty much do the trick of easing the discomfort. So massaging, warmth, prefeably moist warmth, and rigorous, maybe even agressive breast emprying will do it. Not taking of the edges, no brief letting go of the milk ejection reflex, but emptying as far as possible and then take a fresh start.
Warmly,
Gonneke, IBCLC in PP, LC lecturer in southern Netherlands
--- On Wed, 12/23/09, Rachel Myr <[log in to unmask]> wrote:
From: Rachel Myr <[log in to unmask]>
Subject: [LACTNET] discomfort from engorgement
To: [log in to unmask]
Date: Wednesday, December 23, 2009, 1:18 AM
Believe it or not, women in Norway are advised to use heat for this, in the form of scarves around their upper bodies or wool underwear, and they are often sent to take hot showers and 'massage' their breasts though the exact technique is not well described. It works approximately as well as doing nothing, i.e. the engorgement eases up after a couple of days.
RPS is becoming widespread since Ammehjelpen and the midwifery journal published a translation of one of Jean's early pieces about it some 7 years ago, and a summary of the article was included in an appendix in the Norwegian version of the BF triage tool. Since it deals with the engorgement itself, of course it relieves the discomfort too.
There is a very strong belief here that cold causes mastitis. Even sitting in a cold draft can bring it on. Sitting on cold ground is also believed to cause bladder infections. A lot of us might be more inclined to blame a pathogen in a place it doesn't belong for both conditions, but here a woman wouldn't dare take the risk of mastitis from icing down her nipples. Cultures are different.
There is almost no research on the treatment of engorgement or its concomitant discomfort in breastfeeding mothers, which is remarkable when one considers how many women are plagued with it, and how many small problems turn into big ones when complicated by engorged breasts. Cabbage leaves have been shown to be more effective than nothing, and synthetic oxytocin nasal spray has not been shown to have any effect on on engorgement. Apart from that, it's all wide open.
Rachel Myr
Kristiansand, Norway
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