Hi!

Most cases of babies having trouble with latch on on after a few days of
breastfeeding quite weel have to do with the swelling of the breast, even
without an actual engorgement. The breast swells slightly ( mother does not
notice the change yet) and because the tissues are harder to compress, baby
has difficulty. If pushed into the breast repeatedly or forced onto the
breast, baby will arch and refuse.

Teaching mothers to hand express is always important, but in these cases, it
is esential. Heat can also help.

The only article I have read about cold vs hot treament for engorgement is
an editorial in Breastfeeding Abstracts titled "Engorgement revisited" I
think it is in one of the 1992 issues. I will try to find it.
Dany Gauthier, IBCLC
Lactation consultant at Ste-Justine Hospital, Montreal
Quebec
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