Cindy writes:

<< Another question arises from reading this wonderful group think on
 engorgement:  why is pumping mentioned so often as an engorgement
 treatment? It sounds as if pumping may have become the second line of
 treatment after application of hot/cold for many practitioners.  Why is
 this--where is the baby in the midst of all this treatment? >>

Pumping is used ONLY if the baby is unable to latch on to the flattened nipple
or absolutely refuses the br because he is now unfamiliar with the shape,
texture, and feel of it.

If the baby can latch on, and does, and breastfeeds effectively, certainly no
use for a pump.

BTW, went in this morning (7:30 am on a Saturday -- cruel & unusual
punishment, especially since Wheaton got hit with the first snowstorm of the
season -- let alone the year) to see my chiropractor for my painful arm.  He's
been having me ice it -- so I asked him why ice instead of heat (though I
thought I knew the answer, I figured given our discussion, it would be
helpful).  His response ran something along these lines.  "You should never
use heat on a sports injury or any portion of the body that has swelling.
Localized heat applied to the spot brings more blood to the surface, causing
congestion, engorgement and stasis."  (I thought it was interesting he used
the latter two words).  He went on to say that all the newer literature stated
that heat is OUT, cold is IN.  However, he did say that if someone wanted to
use total body heat, such as a warm shower, that would be OK, but hot packs to
a part of the body was not appropriate -- even 24 hours after a specific
sports injury, ice/cold need to be used to decrease the inflammatory process
that is inherent with swelling.

I mentioned lactation to him, and engorgement -- he's not an LC, but is very
familiar with the use of cabbage for swelling, and completely agrees that
localized heat to the breasts is inappropriate -- unless, he said, you use
alternating hot packs and cold packs to the breast.

OK, when I go in on Wednesday, I'll ask him about using heat for mastitis....

Jan -- still thinking, even though it is 1999.