I use both heat and cold when treating engorgement, depending on the
situation.  When there's mild over-fullness, getting the mother to take
a shower with warm water is relaxing and is all that is needed to get
things moving.  If there's true engorgement - the breasts look like two
watermelons and are rock hard and hot to the touch, I prefer cold.  Get
the swelling down with cool cabbage leaves or a package of frozen peas
over a cloth diaper.  Although it is VERY time consuming, I like to
massage the breasts by hand instead of using an electric pump.  Using a
natural, neutral oil like almond, I work around the breast like a clock
- back to front.  Small, circular motions using the tips of the fingers.

Susan Nachman-Srebrnik, IBCLC
Ranana, Israel

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