Regarding the question about milk supply following severe engorgement:
there is information in the literature reporting that severe engorgement
can damage the alveoli which impacts milk supply, possibly forever! This
is reason enough for us to caution moms about letting engorgment reach
such levels. I'm finding that many of our c/s moms get reglan as a
anti-emetic and they get HUGELY engorged by day 3. I'm on the lookout
for this daily.  The nurses are getting better at catching it before it
is really serious and yes, we are keeping cabbage leaves in the refrig
here on the unit. I don't mince words either when I work with a mom who
is severely engorged.....tell her it is ESSENTIAL that we deal with this
NOW or it can have serious consequences.  OK, off the soap box for now.
mary kay smith, IBCLC
Romeoville, IL near Chicago

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