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Subject:
From:
"Mary Kay Smith, RN, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 20 Jul 2004 11:24:43 EDT
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I've been reading but not registering...trying to catch up on jet lag from
ILCA. I want to add the caveat about agressive engorgement treatments for
someone who has implants. RPS (reverse pressure softening - look it up in the
archives) may be a bit agressive and risks bruising the breast tissue and even
rupturing implants. Many years ago, one of my first hospital patients with
severe engorgement that was NOT resolving with traditional measures, just
happened to mention the implants after I commented on firm "ridges" under the  arms.

Cabbage and cool compresses were most effective along with frequent,  regular
pumping. We did use some warm compresses very briefly  once or  twice, just
on the front of the breast prior to pumping. Once we got a milk flow  going,
and latched baby to the breast, things resolved fairly quickly. Mom needs  to be
reminded that treatment measures must be done more than once and that this
engorgement is normal but excacerbated by the implants.

In the last few years, I've been using breast shells to treat engorgement
when mom is resistant to pumping or unable to be compliant for a period of time.
 It will make milk leak and that's the whole purpose - to relieve the
pressure.  Don't forget that engorgement itself can lead to diminished milk  supply
and the beginning of the end.

Mary Kay Smith, RN, IBCLC
Canton MI

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