LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Anne Grider <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 30 Dec 1998 12:01:27 -0500
Content-Type:
text/plain
Parts/Attachments:
text/plain (50 lines)
I realize that this thread has gone on for awhile, but I find that most
posts have left out a lot of details.  In the Atlanta, Georgia greater metro
area I "hear" of a lot of severe engorgement.   Mothers contact me in one of
three capacities: a LLL Leader volunteering on the central phone, or a
private practice IBCLC who does in-their-home consultations, or as the owner
of a breast pump rental station.   I use the word "hear" because I rarely
see these mothers. They phone me at 3-7days describing enlarged, very firm
breasts, hard areolas, flattened nipples that baby can't stay latched onto,
and /or milk will not flow.   For years I've given the following cold
treatment advice and find it almost never necessary to actually see them.  I
talk myself out of a lot of work and income!

I recommend that Mom ( preferably her helper) break up ice cubes and put a
very little bit into as many plastic sandwich bags as necessary..  Mom is
flat on her back, a receiving  blanket or other cloth over her torso, the
bags distributed over everything that's swollen - breasts, shoulders,
underarms - wherever- then another light weight cloth placed over all to
keep bags in place.  I recommend 30-40 minutes- with breaks, if needed- then
immediate hand expression or pumping with hospital grade pump on low suction
and high speed until areolas are soft and  compressible. Then try to get
baby to take over. I recommend keeping baby with mother, encouraging nursing
as often as baby will cooperate until mother is totally comfortable. If baby
is unable, then I recommend the use of the aforementioned pump whenever Mom
begins to feel firmness- for about 10  to 15 minutes if baby not nursing at
all or less time if baby is cooperating to some degree.  Unless something
else is going on like mastitis, extremely negative visitors, on her feet too
much,etc., engorgement is usually resolved in less than a day.  I check most
of my outcomes so I know it's a very high percentage - over 95%- I'm sure.
Very rarely does a mother tell me that she needed to ice more than once or
twice to be able to keep the milk flowing.
As a private practice LC I would find a visit during severe engorgement to
be too long and stressful for most mothers.  I almost always recommend that
she reduce her swelling with  cold, get some rest, then I'll come to help
the nursing, if still needed.  They generally don't need a consult after
that unless they've allowed the baby to crack the nipple/areola during that
basketball-hard stage, or they were trying to use a pump with suction too
strong and that cycled too slowly .
I've not had much experience with cabbage mostly because I am reluctant to
send mother to the store, or her helper, if she's lucky enough to have one
in this very transient community. Ice and sandwich bags they usually have on
hand- at least enough for one time. After that, two wet, shaped, then frozen
disposable diapers are good choices.  I've never been fond of bags of frozen
vegetables because they tend to be too small to cover everything and  also
too heavy.
 Hope others find these methods as effective as I have. Sorry for the loss
of revenue!

Anne Grider, LLL, IBCLC  Private Practice
Marietta, GA, USA

ATOM RSS1 RSS2