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 [log in to unmask]