Again, I am behind in reading posts (it's amazing how many can
acumulate in 36 hours!) so sorry if this is a repetition of what
others have said.  Here is my current thinking - subject to change
if new evidence comes to light.
I no longer suggest warm for initial engorgement/fullness in light
of recent studies.  I suspect that in these cases, the swelling that
accompanies the establishment of full milk supply is the primary
problem.  Warmth only increases circulation/swelling.  However, if a
mom reports she is leaking freely and wants to let warm water run
over her breasts in the shower, it is probably OK.
On the other hand, with later mastitis and fullness, I think the
milk volume/backup is more likely to be the problem and in this
case, warmth can help.
Winnie Mading RNC, IBCLC

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