Terriann Shell's post about her conversation with "Coach Smith" on the
topic of mastitis reminded me of Linda Smith's excellent presentation at
the Private Practice LC Workshop in March 1998.

She explained:  edema in the breast (build-up in cell tissues of extra
fluids) may have three causes: (1) milk stasis ("unremoved" milk -- caused
by a whole host of possibilities), (2) infection, or (3) inflammation
(which can be triggered by stasis and infection, too!).

Heat is not appropriate for infection or inflammation -- and the only
thing that effectively addresses stasis is milk removal.

Her suggestions:  for edema, use: "cold, then no cold" (room temp. or
cooled cabbage leaves are fine); for mastitis, use: "cold, rest, empty
breast."  Mom wants heat?  "Put a heating pad between her shoulder
blades!"

I know I wasn't the only LC to be surprised to "un-learn" the
heat-rest-empty breast mantra.
===
Liz Brooks, JD, IBCLC
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