I had always learned to use heat (even with engorgement)but then some 
conference I attended suggested the use of cold as well. The concept was 
also presented that either hot or cold could work and it was more important to 
concentrate on what FELT better to the mother who is experiencing the 
problem.

One time I can remember a client who was so engorged, her berasts were 
shiny. I decided to try the hot/cold choice with her and she chose COLD. So I 
went along with it and she was able to pump a lot of milk in a very short time; 
resulting in a relief from that engorgement and immediate increase in overall 
comfort. That one case had the most dramatic results I had ever seen. I 
continue to give the mother the choice when the situation is appropriate. 

Betsy Riedel RNC, IBCLC
Connecticut

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