i find it is always important to evaluate whether a mother with extreme
engorgement has generalized edema; it doesn't seem that the breasts can
improve unless the overall edema is addressed, which means i generally tell
them to call their doctor right away (even if it is the middle of the night
on a holiday weekend) and discuss the problem. if a diuretic is needed, the
breast engorgement can be dramatically improved once it is started.

carol brussel IBCLC

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