Dear Denise, Thankyou so much for your clarification and indepth answer. When used as a last ditch attempt to relieve engorgement, we have only used luke warm to cool water with the epsom salts. One mother requested ice in her bowl and loved it, much like cows who go down and immerse in the local creek for relief of their engorgement! Cool with engorgement and heat with mastitis. Yes, thankyou for that. When used we have had good success in both situations. It was recently(last week) pointed out that the treatment is not actually research based so we may need to delve further or ditch the treatment. The whole issue of heat versus cold is divisive and many articles quote use of moist warmth and hot showers but my experience has also found immediate relief with that but subsequent massive throbbing=increased vasodilation and all the things you wrote about. I like a Marsha Walker article including findings by Barnes(relating to ice and sports injury) about vaso constriction within 9 to 16 minutes of ice application followed by reflex vasodilation thereafter ie use the cold then the body takes care of the warmth itself. [from Breastfeeding Abstracts,November 2000, Volume 20,Number 2,pp.11-12]. Use of cold with Reverse Pressure Softening and unrestricted feeding or pumping with breast compression and massage therefore sounds like a good group of offerings for engorgement. It is still amazing to have 2 incredibly diverse/ contradictory treatments for the one situation - Some LC's are adament about use of heat first and others the use of cold.(Aside from the use of Epsom Salts and a soak.) Thanks Cath Williams :) *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html