My youngest just had her wisdom teeth out, one of which was infected and
required antibiotics.  The postoperative advice was to use cold for 24 hrs
to combat swelling (but to limit the cold packs to 20 min so as not to
trigger inflammatory response).  After 24 hrs, the oral surgeon suggested
switching to heat to increase vascularity and help distribute the
antibiotic.  I am always interested in gleaning insights where ever I find
them, and I wonder if there isn't some wisdom there to translate into the
management of inflammatory vs infectious mastitis.  Perhaps when we
encounter engorgement we should consider cold, and if there are sx of
localized pain, erythema, accompanied by cracked nipples, perhaps
fever/headache and more systemic sx we should think heat.
The trouble is that we can't really pontificate about this as there is just
not a good study supporting which to pick when dealing with inflammation of
the breasts.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com

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