I suspect that someof the reason I see severe engorgement occasionally is due
to the fact that many of our c/s moms get Reglan post-op as an antiemetic.
Include the fact that they don't always feed that baby at night (their choice
most of the time) and have a hard time moving around so they "let the baby
sleep" and they have had IV fluid overload.........shall I go on? Most of my
difficult cases of engorgement are this type of patient. The you-know-what
usually hits the fan on the beginning of day three when they are going home.
I don't care what they use as long as it's cold and decreases the swelling.
I've had good luck with a bath or hand towel, wet but wrung out, tossed in
the frig for a few minutes to get REAL cold. Ice packs are useless unless
they cover the whole breast. I could just shoot myself when I see those cute
little latex gloves filled with crushed ice perched on the top 10% of a
hugely engorged breast.  Doesn't do much good there! I also use a pump to
help pull soften the nipple and areola or give the mom breast shells so
she'll leak! Use a folded nursing pad so they don't have the sauna effect on
the nipple. I have had many success stories from those using cabbage. But it
is difficult to get in our hospital.
Signing off in Romeoville IL
Mary Kay Smith, IBCLC

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