Carole,

Engorgement has been poorly defined, at least in the age of perinatal
medicine. Much of the swelling on Day 5 may be associated with relatve
overhydration from intrapartum interventions. Though such interventions can
be absolutely lifesaving at times, nevertheless, IME they often contribute
significantly to breast swelling in the first 7-14 days, depending on how
much IV fluid and how much total pitocin the mother received.

I refer you to my post earlier in the week about reverse pressure softening,
to "free up" as much areolar elasticity as possible no matter what the
nipple eversion or inversion may appear to be or what its cause.

"The physiologic unit of the nipple-areolar complex appears to function as a
closely connected system. Forces acting on any one part of the
nipple-areolar complex may cause other parts to compensate. . . . . . Any
condition causing tissue distortion within the nipple-areolar complex may
interfere with its efficient physiologic functioning during suckling." (2004
JHL article on RPS)

I believe it will help trigger MER and facilitate latching.

K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC
Dayton OH USA

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