Switch to ice before pumping (for about 5 mins, to avoid rebound edema), 
reverse pressure softening to press edema away from the areola, apply 
pump, pump on minimum with breast massage from chest wall toward 
nipple.  She may have to repeat this over and over again for 24-48 hours 
before she has relief, but it is vital she clear this engorgment before 
she involutes completely.
Catherine Watson Genna, IBCLC  NYC

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