Cath writes:
"I wonder if anyone has tried using a system of soaking breasts in a bowl
of warm water to which Epsom Salts has been added. This seems to bring
relief to mothers with engorgement but I am not sure if it is the soaking,
or water temperature or the salts. Keen to hear."

Cath in my experience warmth isn't the best way to go when treating 
engorgement. Using heat at this time is initially soothing - but within an 
hour or less the engorgement is often a lot worse. Heat dilates the blood 
vessels allowing more blood to flow to the area, more of which is likely to 
move out of the vessels and into the interstitial spaces, creating more 
oedema and further blocking the lactiferous ducts and hence milk flow and 
the cycle goes on.
This is the reason that we treat swollen ankles, perineums, knees, whatever 
initially with cold.

Immersing the breasts in Epsom Salts dissolved in warm water has been very 
effective in managing mastitis - not published in any peer-reviewed 
journals to the best of my knowledge, but one of those old wives tales that 
seems to work effectively and can't do any harm. The swelling in mastitis, 
particularly if picked up in the first 24 hours, is limited to a segment of 
the breast and the increased blood flow isn't a problem... and appears to 
be desirable, maybe by bringing more infection fighting blood to the breast.
A while ago I was on a list for homebirth midwives and they were reporting 
success with reducing perineal swelling by using cold epsom salts 
compresses applied to the perineum. I haven't tried the cold epsom salts 
compresses (on either breasts or perineums!), but think perhaps that could 
be more effective for the initial management of engorgement and oedema than 
warm epsom salts compresses.
Do the mothers you've used this with continue to report their engorgement 
resolving? I don't know what the salts do ... so if they do, maybe it is 
the epsom salts.

Denise
PS: Hi Cath :-)

***************************************
Denise Fisher
Health e-Learning
http://www.health-e-learning.com
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