Hi I have been off line for many weeks as I have bee intimitly involved
in the opening of a small rural hospital in Dannevirke NZ. We are on
track to open 7th September 1997. (Moved house also.) Opening three days
away.  To recap I am a midwife and Lactation consultant with out time to
practice properly.
My question, although it has most likely to have been address many
times, but because I do not have the time to reseach properly and need
an instant response if possible is: a Fourth time breast feeding mother
who now is on her fourth day postnatal, at term with a large vigrous
baby and has a rt breast which is engorged/blocked ducts on the upper
50%.  Painfull and hard. No temp.  No inflammation and unable to express
any milk from those affected ducts.  Lower 50% is soft and comfortable.
Can any one explain what is going on and how to help> Have left a pump.
Instructions to hand express, use hot water, cabbage leaves and keep
feeding the infant.  No white spots.  What Next?