Hi all, I confirm Heather's view that there is less engorgement around in
the UK - certainly *severe* engorgement.  Like Heather, I think the
reduction tied in with rooming in, unrestricted and early breastfeeding, and
I think crucially *effective* breastfeeding.  Do we really need to look for
preventative actions against engorgement and sore nipples?  Isn't it true
that a well-positioned baby, able (or should I say enabled) to suckle
effectively, will not damage his mother's nipples?

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 - I think this needs careful thought.  I applaud efforts
to assess interventions in breastfeeding - I would like to think that
optimising the physical mother/baby interaction would be fundamental to any
such study.

In case you think I am getting too big for my boots (do I hear laughter from
other UK types?), I remember hearing Peter Hartmann speak a couple of years
ago.  He said that in his part of the world (Perth, Western Australia) too
little milk was not seen as being a problem - but I think he did say they
saw a lot of engorgement.  Any Aussies want to tear themselves away from the
barbie to comment?

We're now getting ready for *real* Scottish holidays - Hogmanay.  And I'm
off to the country to enjoy it.  For the geographically inclined, I'll be in
the house where I was born, on the shores of Loch Fyne, in Argyllshire.  (On
the west coast of Scotland, where we don't get much cold weather, and
rhododendrons flourish.)
Mary Broadfoot, Paisley, Scotland
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The Breastfeeding Network - Independent Support and Information about
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