Humenick and Hill published 2 classic articles in J Hum Lact 1994, 10(2) on
the occurance of engorgement.  Patterns of engorgement vary, and one
commonly experienced pattern was marked by intense, enduring engorgement
that could persist for up to two weeks.  This is a pattern that often
results in greater risk for weaning for obvious reasons, but it did not
necessarily result from mismanagement of lactation (i.e. not feeding/pumping
enough early on).  They also discovered that previous breastfeeding
experience was an important variable in predicting engorgement  "Second time
breastfeeding mothers experienced engorgement sooner and more severely than
did first time breastfeeding mothers."

I have managed many moms  with subsequent babies who were 'super-producers'
with baby #1 who did everything we could both think of to reduce/prevent
engorgement  (including keeping colostrum drained) to no avail.  They still
got engorged.  So I don't think we do "know" that early pumping protects
against engorgement.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com

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