Loni Denman, RN, IBCLC wrote:

"We used to suggest ice packs for perineal discomfort for 24 hours until we
learned at a conference that studies were showing episiotomies were not
healing well, due to prolonged lack of circulation.  Speaker suggested 6
hours TOPS, to reduce swelling, was all that was necessary.  After that,
sitz baths to bring much needed oxygen to the area to promote healing.  How
long do you keep an ice pack on a swollen ankle to reduce swelling?  Guess
any swelling that is going to happen will happen in those first few hours."

In response to your questions, we use ice on the perineum for the first 24
hours not only to reduce edema but to increase the woman's comfort.  We
limit applications to 20 minutes at a time. (I think my first post made it
sound like we left ice on the entire 24 hours, which I can see would reduce
circulation and prolong the healing process).  During the first two hours,
it serves to decrease edema and increase her comfort.  After the first two
hours, it seems to provide more of an anesthetic effect.  Then we go to
warm sitz baths after twenty four hours, though I'm trying the cool sitz
baths with some patients with good results also, thanks to a suggestion
from another list member.  However, I'd be interested in the studies you
mentioned.

Maurenne Griese, RNC, BSN, CCE, CBE
Birth and Breastfeeding Resources  http://www.childbirth.org/bbfr
Manhattan, KS  USA
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