Re: aspects of Martha's and Jean's posts that referred to:

<< Martha Johnson writes: <I have recently run across another technique in
Sheila Humphrey's Nursing Mother's Herbal, which is a FANTASTIC treatment
adjunct to RPS for edema... I've had amazing success with this technique
on very congested breasts, in the following order: 1. Mom lies on her
back in bed. Apply moist heat for 5-10 minutes... >>

<< Jean C writes: It is good to know there is an easily accessible book for those wishing to know more about this...
"Under normal conditions, 90% of interstitial fluid re-enters the venous
end of circulatory capillaries, while the remaining 10%, including
protein molecules, re-enters lymphatic capillaries...
(2) the appropriate direction for any massage
depending on whether the immediate goal is to move milk or edema, (3) the
possible therapeutic value of gravity in helping resolve severe breast
edema, and (4) the possible therapeutic value of assisting lymphatic flow
by active/ passive motion of arm and chest muscles... 
One of my goals was to challenge researchers to consider intravenous fluids and edema as variables in future engorgement research, and stimulate more appropriate choices in nursing interventions...>>



We have an apparent discussion re: edema and fluid stasis in the breast with severe (pathological) engorgement. But Martha recommends moist heat pre-toward-chest-massage and indicates anecdotal "success" with it. 

My understanding is that there is no research literature supporting the use of heat with edema, but there is support for applying cold to edematous areas. Since I wouldn't want to possibly compound edema, I'd appreciate more discussion/research-based refs on this aspect. Thanks.

Karen

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