I appreciated Mary Broadfoot's comment "I hear what is being said about
evidence based practice - I do however wonder whether it is always
appropriate to apply evidence about other body parts to the breast..."
Nikki Lee also asks some interesting questions:  "Does it matter that the
breast, unlike an ankle, has an outlet to the outside for drainage? So
while we need to do things to promote flow internally to an ankle or
muscle, we need to do things to promote internal and external flow in a
breast?"

Thinking of the breast as a secretory organ experiencing greatly increased
vascular and lymphatic input while going into full swing of milk production
is quite different than thinking of injured muscle and tendon.  What
comparative treatments do we have for other external secretory organs -
tear ducts?  sweat glands?

Another question arises from reading this wonderful group think on
engorgement:  why is pumping mentioned so often as an engorgement
treatment? It sounds as if pumping may have become the second line of
treatment after application of hot/cold for many practitioners.  Why is
this--where is the baby in the midst of all this treatment?

Cindy Turner-Maffei, Massachusetts, USA