MaryKay writes,

<<  I'm using the Breastfeeding Answer Book and Auerbach
 & Riordan, plus info from the Lactation Educator UCLA program that
 supports heat, not ice on a lactating breast. >>

Since the engorgement is caused by edema in the tissues, extra blood, and
extra lymph, putting heat on the breasts will bring more blood to the area,
causing further compression of the ducts and decreasing the ability of the
milk to let down.  PUmping will only help if the edema has decreased enough
that the milk is able to get through the ducts.  Cabbage will reduce the
edema, as will icy cold compresses.  Heat on the back of the mom's neck will
help her to relax, thus facilitating MER if it is tension that is causing a
problem.  Once the cabbage is on for a reasonable period of time (which,
depending on the mother, may be anywhere from 15 minutes to several hours),
pumping should help tremendously.

Do I know any "research" in a medical journal supporting this?  No.  Only
clinical evidence.  Do I have any research supporting use of ice instead of
heat?  It's based on medical-surgical nursing/medical practice for edema.  Is
there current research supporting use of heat on an engorged breast?  None
that I am aware of, but maybe there is something out there??

Jan Barger -- in cold Wheaton.