Snowden et al., in a systematic review of the literature
including eight randomized or quasi-randomized clinical
trials, concluded that there is no scientific evidence that
treating breast engorgement with ultrasound, oxytocin or
cold compresses is efficient in alleviating the symptoms.
The use of anti-inflammatory drugs was the only treatment
that proved to be efficacious.5 Although the efficacy of
cold compresses (or of a cloth-wrapped ice pack) for the
relief of breast engorgement symptoms has not been
confirmed, they may be useful in reducing milk production.
Local hypothermia produces temporary vasoconstriction
and, consequently, reduces blood flow, with consequent
reduction of the edema, increase in lymphatic drainage
and lower milk production. These cold compresses should
not be used for over 15 to 20 minutes.6 On the other hand,
warm moist compresses produce vasodilation, alleviating
local compression, but, later, they increase the volume of
milk in the breasts, which can be a disadvantage in the
presence of breast engorgement.