I was married for fifteen years to a chiropractor ......his office
forwarded all  incoming calls to our home after hours (notice I said "was"
)......if a patient sustained trauma or an acute pain or injury he told them
to ice it down (the RICE acronym)..... if they were existing patients or had a
recurring problem then his advice was heat (to comfort and help the spasm, if
I remember correctly)......
     This heat and ice thread may be getting tedious to some of you, but I am
reading with great interest as our current written "take-home" instructions
are "warm moist compresses for five minutes or longer to soften and gentle but
firm massage for 2-3 minutes and manual expression to soften areola before
nursing if breasts become uncomfortable."
    After nursing it reads "ice compresses for a short period to decrease
swelling and take ibuprofen as directed by your doctor" if breasts are
uncomfortable....
    I would like to update this info if it is not in keeping with current  and
non-detrimental recommendations....anecdotally, I had a "walk-in" mom from
another hospital that had been discharged after giving birth to a 26 week
gestation baby boy......she had been given a pump kit and directed to a
medical supply pump depot in her hometown 30 miles from Charlotte....it was
Christmas Eve day.....they were closed...she had not pumped, except with
limited success with the manual portion of the kit, for over 36 hours....they
somehow got to us and she was at what my colleague
Robin calls the "pop and die" stage......in other words, her breasts were
ready to pop and she felt like she could die!!  Her nipples were barely
visible.....after applications of warm moist disposable diapers she pumped 6
ounces......she rented a pump and left a happy camper......
    As someone said in the last post, I think a forum like this is so valuable
for this kind of collective exchange.  Perhaps, along with Alison's
references, we will see more research done as a result of this discussion.
Thank you.

Jan Ellen Brown RDH IBCLC
Charlotte, NC