Leslie says,

<<  What I was mostly objecting to was the
 lumping of people who use heat for engorgement into the same group as those
 who are truly NOT following current thinking. I think, however, it would be
 fair to say that people who are using ONLY heat are behind the times and
 need to look at their practice,  >>

I think if you go back and look at my post, what I was objecting to originally
(which is what brought up the whole issue of engorgement) was the one-week
wonder RN who, because of previous mother-baby experience, qualifies to sit
for, and ultimately passes the IBLCE exam -- but NEVER changes her practice,
nor communicates with colleagues, or joins the local ILCA affiliate (if there
is one), or goes to conferences -- or even reads the JHL.  I cited several
things as an example (can't remember them all right now), including rigidity
about waking a deeply sleeping baby to feed JUST because it has been 3 hours
since the last feed (never mind that he's fed 4 times in the first 13 hours of
life), topping off with a bit of formula for a fussy baby, using X bottle
"because it is most like mother's breasts and won't cause
confusion/preference," AND packing the mother in hot moist compresses for
severe engorgement....

So, I apologize if all of you who are using a bit of warmth to the breasts
mistook that post for YOU.  I also remember I said that if you were reading
and responding to Lactnet, you were probably NOT one of the people to whom I
was referring.

But I would STILL like research to support the use of heat to the breasts.  As
Linda Smith said, if a glass of Scotch makes the mom feel better, would we go
pour it for her?  And wouldn't heat to the back of the neck help the mom
relax?  Can we accomplish what we need to accomplish without increasing edema?

I don't see nearly as much engorgement as I used to because I think moms are
being given better instruction.  But I do see it enough that I think we need
to treat it appropriately.

And I'm looking for evidence based practice.  So whomever is working on a
master's degree and needs a thesis, or whomever wants to publish a great
article in the JHL -- please go for it!!!

Jan Barger