|What Are Engorged Breasts?
This is where the breasts become full of milk and can swell up to twice their normal size. They may also become hard, sore and painful. All mothers produce milk after childbirth and all develop some degree of engorgement before feeding is established and milk production settles down and adapts to the needs of the baby. Engorgement typically occurs between days 3 and 5 after childbirth. However it can happen at any time while nursing. For example you may experience engorgement when your baby is weaning and starting to eat solid foods. As he no longer gets all his nourishment from breastmilk the breasts are not completely emptied and excess milk begins to accumlate. It takes the body a few days to register that milk production needs to be cranked down. Engorgement usually resolves within a day or two and the breast softens up so you feel comfortable again.
What Are The Signs Of Engorgement?
• Breasts feel swollen, throbbing and lumpy.
• Breasts are uncomfortably full to the point where nipples flatten out into the areola.
• Swelling can extend to the armpit.
• There may be a low-grade fever.
A fever higher than 101 F or severe pain can signal a breast infection (mastitis). Call your doctor immediately if this happens.
How Is It Treated?
Nurse, nurse and nurse again! It is the baby's job to help the mother through engorgement by emptying the breasts of milk. Don't be tempted to skip feedings because a breast is too sore, the fuller the breasts become, the more they will hurt. Look for signs that your baby is hungry, such as sucking his fist or becoming cranky, and feed him straight away. Within a few days the breasts will adjust and start to make just the right amount of milk needed. In the meantime:
1. Apply moist heat to the breasts before feeding. This helps milk to flow (you can use a hot face flannel or take a quick shower).
2. Apply a cold compress to the breasts after feeding to reduce swelling.
3. Gently press on the areola (dark skin surrounding the nipple). If the breasts are very engorged fluid can gather in the areola tissue making the nipple flatter so that baby finds it more difficult to latch.
4. Massage the breasts while feeding, this encourages milk flow and will help relieve tightness.
5. Some women find wearing a well-fitted nursing bra (even at night) for support helps relieve pain - others find it better to go bra-less. Discover which is best for you.
6. Ask your doctor about taking ibuprofen for pain-relief.
7. The once-off use of a breast pump to express milk should help relieve particularly painful inflammation. Return immediately then to breastfeeding-only to manage engorgement.
8. If your baby is premature or cannot be breastfed, a hospital grade pump can help you through engorgement until your baby is ready to breastfeed.
9. Clean some cabbage leaves and place in the fridge for cooling. Once cooled, put them inside your bra. They may help (natural remedy) to draw water out of the breast, as well as provide a soothing cooling effect. Change the leaves when they become damp.
10. There is some evidence that acupuncture can help relieve symptoms of engorgement.
11. Continue to drink liquids as normal. Drinking less will not reduce the level of fluids in your breast.
How Long Will My Breasts Stay Engorged?
If you feed on demand (as often as your baby wants) and he latches on well (see how to breast feed), engorgement should not last longer than 48 hours. If it continues for longer talk to a lactation consultant or doctor about breastfeeding positions and techniques. Nursing can take time to master and most moms need a little guidance before they finally start to enjoy the experience.
Bottle Feeding And Engorgement
If you bottle-feeding your baby and do not plan on breastfeeding, you will probably experience some engorgement within the first few days of childbirth when mature breast milk comes 'on tap'. As you can't breastfeed to relieve the pressure you may find wearing a well fitted bra and taking painkillers helps to relieve the pressure until milk supply dries up. If engorgement is very severe, you might have to express a little milk by hand (once off) to relieve swelling.
How Can Engorgement Be Prevented?
As engorgement is caused by excess milk in the breast, ensuring that milk is removed efficiently is the best method of prevention. This is done by:
• Feeding frequently so milk is removed.
• Ensuring that the positioning and latching are effective.
• Avoid taking your baby off the breast before he is finished feeding.
• Avoid relying on pacifiers and bottles to supplement feedings. It can make the baby lazy about latching on the breast. This will also help prevent a host of other breastfeeding problems like sore nipples and milk blisters.
Your Personal Stories
I didn't want to breastfeed so the nurses at the hospital binded my breasts with ace bandage. It hurt like crazy but my milk totally dried up after 5 days. I found ibuprofen helped me a lot, but I've heard aspirin and Tylenol are just as good. I also heard cabbage leaves are good, but I didn't try those.
I had engorgement 6 months ago when my baby was born. They sent me to a lactation consultant because they were worried it would get infected and I'd end up with mastitis. I did want to breastfeed but I wanted the pain to go away. The only solution was to breastfeed, even if it killed to touch the breasts. I prevented clogs in the ducts by pressing the breast gently from the armpit area down to the nipple while my baby was suckling. The consultant showed me how to do this but I almost fainted with the pain. I used warm compresses on the breasts before feeding to get the milk flowing. Then I used cold cabbage leaves after to stop the flow. It took about 2 weeks to sort, and my baby had to learn how to latch correctly as well. Once it was over, I never looked back.
It's been a gradual reduction for me. When my baby was born 3 weeks ago, my breasts quickly became engorged and full. They felt bruised near the armpits and I must have developed clogged milk ducts because I had shooting pains in my armpits. I did lots of massage to help relieve it, it lasted about 3 days. Now, 3 weeks later, my milk supply has reduced a lot and I'm only engorged when I wake up and the baby has not eaten for 6 hours. Breasts are still feeling tender, but nowhere near as bad. I tried hot showers, but it never helped.