Heather writes:
<Severe engorgement is a consequence of postnatal practices that keep
mothers and babies apart and prevent them feeding when they want to.
I'm guessing this is what makes the engoregment you describe so
common in Spain, Carmela?

One thing we get right in the UK is keeping mothers and babies
together and not scheduling feeds (there is plenty else we get
wrong!). We have had routine rooming in for more than 20 years.>

How common is it in the UK for mothers to get 2 or 3 or more liters of
fluid intravenously in the intrapartum period, for induction,
augmentation, epidural management or operative delivery? Or immediate
antepartum IV fluids to stave off premature labor? Retained fluid in the
body in general (in which the breasts often participate) can occur before
engorgement comes on, and/or coincide with and complicate engorgement
itself. That is a large part of the latching difficulties we see in
midwest USA during the first 14 days after birth. At one time in my
career when my hospital adopted family-centered maternity care with
nearly universal rooming in, I thought "Now! Finally! We'll avoid
engorgement!" That has not proven to be true and in fact, is many times
now worse than in past years since the "epidemic" of managed labor has
swept over our location.

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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