June,

What I've found works best for engorgement and expression-

-Warm (not hot) compresses or warm shower (no water hitting the breasts
directly, this can stimulate too much) before feeding/expressing.  Ice
beforehand
-breast massage before and during (see
http://newborns.stanford.edu/Breastfeeding/HandExpression.html)
-oxytocin-releasing measures during, to help with milk ejection (mom should
be comfortable, maybe listen to music that is relaxing for her, have someone
give her a foot massage, warm washcloth or pack on her neck/shoulders etc.)
-during let-down hand-express the side that the baby is not nursing on
-cool compress afterwards.  Avoid putting ice directly on the breast, and
instead use cool washcloths or gel pack from the fridge, wrapped in a damp
washcloth to help bring the swelling down.
-homeopathic oral arnica  (for those who are familiar with homeopathics) to
bring down the swelling
-ibuprofen if needed for pain and inflammation

In addition to recommending it to clients, I used this protocol myself 5
months ago when I was a new mom, and it worked very well!

Good luck,
Sharon



On Sat, Jul 16, 2011 at 12:56 PM, june & john <[log in to unmask]> wrote:

> Hello Wise Ones
>
> I would like advice about  management of a   mum who has had  mastitis for
> the past 11 days.
>
> Admitted to hospital and decided to rest her nipples for 24 hours, I have
> never seen such damaged nipples the end of each nipple was severed.
>
> I am troubled that I wasn't able to get the affected breast flowing, I
> tried, ice packs, hand expressing,  light reverse pressure softening, and
> lots of pain relief,  nothing worked!!!!!
>
> Finally  after working with this mum all day she  agreed to put her baby
> daughter back to the  affected breast with a shield , baby did  soften it
> slightly, when she became fussy she was then switched to the other breast
>  then  mum managed to  express around 5 mls.
>
> What I would like to know is there other techniques that could I could  be
> using?
>
> What is breast stripping?
>
> Most of the protocols I have read suggest heat, I was under the impression
> that heat on mastitis can increase the edema and ice is recommended
>
> Sincerely
>
> June Nicholls
> IBCLC/Midwife
>
>
>
>



-- 
Sharon Craig Economides, LM, CPM, MMid, IBCLC

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