My problem with engorgement is that it ranges from breast fullness to complete breast congestion and no milk flow. I manage women with no milk flow differently to those with normal breast pain related to breast fullness, changing breast tissue and loads of milk. So I only tell a woman that she is engorged if she has no milk flow. I really try to normalise full breasts both with the women and the health professionals working with them. The women with true engorgement are rare and usually women whose babies are in the neonatal nursery and the mother is only intermittently expressing. So I work with the woman showing her how to use breast massage aiming at draining the blood and lymphatic systems in conjunction with frequent expressing. Cold compresses work well after the "feed". However we have a vast range of cultural groups and I talk to the woman about what works best for her. I generally do not promote the use of heat as this compounds the already congested breasts - remember there is no milk flow for these women. I am currently collecting case histories on these women to do a paper as they are really few and far between in our unit. Gwen Gwen Moody CNC Postnatal Care Westmead Hospital PO Box 533 Wentworthville 2145 Phone: 02 9845 6964, 0422212774 Fax: 02 9845 8340 Page: 02 9845 5555 - 01135 email: [log in to unmask] >>> [log in to unmask] 23/12/2009 11:18 am >>> Believe it or not, women in Norway are advised to use heat for this, in the form of scarves around their upper bodies or wool underwear, and they are often sent to take hot showers and 'massage' their breasts though the exact technique is not well described. It works approximately as well as doing nothing, i.e. the engorgement eases up after a couple of days. RPS is becoming widespread since Ammehjelpen and the midwifery journal published a translation of one of Jean's early pieces about it some 7 years ago, and a summary of the article was included in an appendix in the Norwegian version of the BF triage tool. Since it deals with the engorgement itself, of course it relieves the discomfort too. There is a very strong belief here that cold causes mastitis. Even sitting in a cold draft can bring it on. Sitting on cold ground is also believed to cause bladder infections. A lot of us might be more inclined to blame a pathogen in a place it doesn't belong for both conditions, but here a woman wouldn't dare take the risk of mastitis from icing down her nipples. Cultures are different. There is almost no research on the treatment of engorgement or its concomitant discomfort in breastfeeding mothers, which is remarkable when one considers how many women are plagued with it, and how many small problems turn into big ones when complicated by engorged breasts. Cabbage leaves have been shown to be more effective than nothing, and synthetic oxytocin nasal spray has not been shown to have any effect on on engorgement. Apart from that, it's all wide open. Rachel Myr Kristiansand, Norway *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome ______________________________________________________________________________ This electronic message and any attachments may be confidential. If you are not the intended recipient of this message would you please delete the message and any attachments and advise the sender. Sydney West Area Health Service (SWAHS) uses virus scanning software but excludes any liability for viruses contained in any email or attachment. This email may contain privileged and confidential information intended only for the use of the addressees named above. If you are not the intended recipient of this email, you are hereby notified that any use, dissemination, distribution, or reproduction of this email is prohibited. If you have received this email in error, please notify SWAHS immediately. Any views expressed in this email are those of the individual sender except where the sender expressly and with authority states them to be the views of SWAHS. *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome