Hi Toby Gish!

I recall that Niles Newton described levels of engorgement in one of her
works. Linda Kutner or Jan Barger may have the reference - wish I did.

I'm abandoning the catch-all phrase "engorgement" and attempting to
distinguish "too much milk all at once" from "edema" and "milk stasis."  They
are distinct phenomena and require different treatment even though they can
occur simultaneously.  Trick, of course, is to treat the most urgent one
without interfering or exacerbating another one. That's why I dont' believe
in using heat for early-postpartum full breasts. Edema is a big factor in
this, and heat is never used for edema anywhere else in the body.  Cold will
reduce the swelling, which then unblocks the ducts so milk can be removed.

Linda Smith, applying science to breastfeeding management whenever possible
private practice in Dayton, OH