Let me introduce myself. I am a former lurker, now posting for the
second time. My name is Gail Davis. I am a public health nurse,
IBCLC, working in San Francisco, Ca. I work with a diverse population
of low income women.
I followed the topic of engorgement with great interest. On the issue
of use of cold, I thought it would be good to share some cultural
information. Let me say that I am by no means an expert, but have
learned some things in my 17 years of working with Black, Asian, and
Hispanic women.
For many women of these cultural groups, there is a postpartum lying
in, during which cold is to be avoided. The thought is that birth
causes the woman to be "cold" or "open" (vulnerable?) During that
time, she may be advised to avoid bathing, shampooing, or eating
"cold" foods. (In many hospitals here, ice water is never given to
Asian women after delivery. Rather hot water is given in a thermos.)
If a postpartum woman breaks the cultural rules, she may fear that she
has ruined her chance to breastfeed, and that her milk will go bad or
dry up. For many of these women, the elder matriarch of her family
has great influence, so even if the postpartum woman herself is
westernized, this cold rule is still followed.
Many of these women are very respectful of authority figures,(the LC)
and may go along with some suggestions (ice) only to later change
their minds about beastfeeding because her milk has "dried up."
I have had Asian women ask me "do I have to eat vegetables?" because
vegetables are considered to be "cold" If I told her "Yes you do
because a well balanced diet is important, blah blah, blah," she would
probably not feel as confident in her ability to breastfeed.
I feel that it is important to be sensitive to these cultural issues.
We all agree that the breast is not an ankle, and that heat may help
in some cases, if only to relax the ducts.
Recently I asked an engorged woman "What would feel better to you,
heat or cold?" She (a Filipina) wanted to try cold. It worked very
well for her. Because she chose, I knew it was acceptable to her. (By
the way, a disposable diapers saturated with water and frozen, makes a
great ice pack.)
Respectfully, Gail Davis, PHN, IBCLC. From San Francisco where I
cross the Golden Gate every day to get to work.
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