I am looking forward to the convention for many reasons, not the least of
which is that I have struck up an e-mail correspondence with Masayo Awano, a
Japanese midwife who will also be attending. I have also invited her to join
Lactnet. I have the permission of Masayo, Liz Brooks and Diane DiSandro to
post the following:

> On May 30, Liz Brooks posted on a method of massage which Diane
> DiSandro came up with:
>
> > I am on another list where recurrent plugs/mastitis-near-misses were
> > recently discussed.  Diane DiSandro has given me permission to share
> > with all of you her interesting post, which is below.
> >
> > I hereby officially dub this the Diane DiSandro Breast Kneading
> > Technique.
> >
> > Now, to her message:
> >
> >
> > I developed this years ago when working with a 6 wk postpartum mom
> who was starting her 3rd course of antibiotics for mastitis.  Her
> mother and  sister  had similar problems...and this mom wanted to
> wean, but couldn't even accomplish that without mastitis.  Nothing was
> working.
> >
> > I imagined what would happen if there were a fibroid cyst or some
> other structural anomaly lying on a milk duct, and repeatedly not
> allowing it to drain properly.  No matter how well we drained and
> treated it, the
> > problem would just keep happening.
> >
> > So...instead of massaging the breast as usual (outer in towards
> nipple), I had the mom imagine that her breast was a bag of marbles.
>  She was to pick up the breast and "knead" it, or rather "mush" it
> around.
> >
> > Place the heels of your hands at the outer edge of breast (around 3
> and 9 o'clock).  Fingertips up slightly interlacing over the nipple.
>  Now, knead IN with your fingertips and also knead with your palms and
> thumbs.
> >  (Are you doing it?)
> >
> > The idea is to move each little marble a millimeter or so to the left or
> > right.  Just a slight shift, since we can't really move them.
> >
> > Do this 3-4x per day.  In the morning shower, at lunchtime, dinnertime,
> > bedtime.  Just move those little cysts (or whatever) a little bit, and
> > later, move them somewhere else a bit.  At least that was my idea.
> >
> > This mom went on to breastfeed for 2 1/2 years with no other mastitis.
> > Until her 2nd child was 8 days old.  She called me in a panic and
> > asked what it was that we had done.  We averted that mastitis, and
> she never got it again.  Her sister also nursed her 4th child (after
> suffering from recurrent mastitis and 2 abscesses with the other
> children) with no problems.
> >
> > I have used this technique with too many moms to count over the
> years now.
> > It really works well when everything else has been addressed and the
> > recurrent plugs or mastitis continue.
> >
> > --Diane DiSandro IBCLC
> >
 I shared that post with Masayo, and she responded:

> I don't know exactly what was happened by reading this mail ....
> Was it really mastitis or galactocel... might be mastitis....
> The way Liz gave that mom sounds a bit similar to Oketani ( traditional
> Japanese massage) way but  actually , I don't understand well this
> following part;
>
> [ Place the heels of your hands at the outer edge of breast (around 3
> and 9
> o'clock).  Fingertips up slightly interlacing over the nipple.  Now, knead
> IN with your fingertips and also knead with your palms and thumbs.  (Are
> you
> doing it?) ]
>
>
> Without knowing how that mom felt, I can not say anything.
> When I do Oketani massage ,  we should never give pain to moms.
>
> If we remember this issue until when we meet in July, would you explain
> me what exactly Liz did to this mom by your understanding ?
>
> Thank you anyway.
> It's interesting issue for me because I thought LC in US would never
> touch breast by hands.  It was good to know I was wrong.>
>

Masayo sent me a translation of the booklet descibing the Oketani method,
and it was fascinating
to see the diagram that indicated that the breast tissue was apparently
being lifted up and
separated from the pectoral fascia. Masayo's other comments in response to
my questions:


> Yes, we have several way in Japan for breast massage.  The
> purpose of those massage is  " increase milk supply ", " relief
> engorgement ", "softening nipple, nipple neck and areola".  (in general [
Japanese
> >     breast massage] ) .
> >
> >     We have deferent way of massage depend on each purpose.
> >     For " increase milk supply "---  mostly massage to  breast basement
> >     using by all fingers and hands.
> >     For " relief engorgement " --- mostly milking on around areola and
> >     nipple, using by fingers.
> >     For " softening nipple, nipple neck and areola" --- almost same
> >     action  as milking but bit more trying  to stretch nipple's neck
> using    >     with  fingers.
> >     When we give massage, with those action, we shouldn't give any
> >    pain.
> >
> >     This is rough idea of Oketani massage that Ms. Oketani
> (1913-2003) created, based upon a practical breastfeeding theory
> and it is a unique management method in Japan.  I have learned this method
from
> Ms. Oketani directly in 1980-1982 and I am one of certificate Oketani
Lactation Management
> Association Member in  Japan.
> >
> >     Most of Japanese midwives have been trying to give massage
> based on this Oketani Massage but this isn't easy to learn, takes days
> and energy.    So, not  so many midwives could do right way. ( But
> they are  trying ...)
> >     In Japan, we have several other massage ways.
> >     One of popular way is in " Breastfeeding and Human Lactation,
> >     third ed."   by Riordan (Jones and Bartlett. 2004, p.228-229).
>  That way is  practiced  by mothers after childbirth, but sometimes
> mother tend to practice  too much, then, it often triggers (cause)
>  worse  breast engorgement.>

Two weeks and counting till the convention!

Now, I really mean it that I am going no-mail for a while.

Jean
****************
K. Jean Cotterman RNC, IBCLC
Dayton, OH USA

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