Engorgement is what happens to your breasts around three to six days after the birth of your baby after a surge of hormones have began to change the composition of your breast milk from the thick colostrum phase to a more mature milk. Colostrum still however remains a part of your milk for several days. Your breasts may feel swollen, fuller, and heavier. In some cases, women describe the breasts as being warm to the touch and appear hard and shiny. You might even begin to notice some reddening of the skin as the tissue stretches. Some women may get a slight fever and experience chills and nausea for a few hours. These symptoms are caused by a sudden increase in breast milk volume as well as an increase of blood and other fluids entering the breast ducts to assist the glands with making milk. Your breast tissue has in fact become swollen or “engorged”. This can last anywhere from 12-48 hours. Engorgement can happen several times through out your breastfeeding experience, and be caused from various fluid overloads, but is most common in the first few days postpartum.
Your breasts are trying to figure out how much milk to make for your baby, so it begins with making an over abundant amount. Your boobs are over achievers already!! In some cases the engorgement is severe which causes breast pain and latching difficulties. They are so hard that the baby is unable to latch on. If you think about it, it would be like your baby trying to latch on to a over filled water balloon! The good news is there are steps to take to help ease this discomfort.
STEPS TO TAKE TO PREVENT ENGORGEMENT
- Follow the baby’s cues for feeding on demand. When the baby begins to elicit a feeding cue, place him/her on the breast. Your baby should feed a minimum of 8 preferably 12 times in 24 hours. Feeding early and feeding often will help to make sure good milk transfer is occurring.
- Signs that your baby is transferring milk are: audible swallowing, sustained sucking pattern with good jaw glides, pausing and self starting by the infant.
- Feed the baby until he/she self detaches, generally around 15-20 minutes per breast. Allow the baby to empty each breast as best as possible
- Provide breast compressions during each feeding session to help aid in milk removal
- If the breasts to not feel soft, or the baby has only nursed on one side, pump or hand express to relieve the fullness for no more then 10 minutes. This will aid is comfort, but also signal to your brain to continue to produce more milk for your baby.
STEPS FOR HARD PAINFUL BREASTS AND LATCHING PROBLEMS ASSOCIATED WITH ENGORGEMENT
- If milk is not flowing well, prior to feeding, apply a cold compress to the breasts for 15-20 minutes. Never apply ice directly to the skin, place a towel or receiving blanket in-between. Use a package of frozen peas, or make an “Ice Diaper” for icing. To do this saturate one of your baby’s newborn diapers then place it in the freezer. The diaper will freeze and voila, you have a self made non leaking ice pack that contours perfectly to your breast.
- Massage the breasts gently from the chest wall toward the nipple area to help relax the breast tissue and increase the milk flow.
- If the areola is to hard that the baby is unable to latch deeply onto the breast, hand express or pump for about 5 minutes to soften the areola. Having the baby latch more deeply will help to prevent sore damaged nipples.
- If the baby does not feed well or is only able to nurse on one side, pump and massage your breasts until they feel softer and more comfortable. It is best to limit this form of stimulation to only 10 minutes as any more may signal your body to produce more milk then it already is.
- It is normal that you may only be able to pump out a small amount of milk from each breast at this time. The majority of the fullness is due to the excess blood and fluids that settled into the breast tissue that obviously can not be expressed out.
- If milk in flowing, take a hot shower to allow the warm water to flow over the engorged breasts. The moist heat will encourage the milk to flow faster. Perform breast massage and hand expression while in the shower to alleviate some of this discomfort.
*** Special Note: Ice is recommended to bring down swelling. Heat is ONLY recommend to eliminate discomfort if milk is adequately flowing or leaking from the breast. If you add heat to a breast, where milk is NOT flowing it can cause the tissue to swell even more.
- Cold compresses in between feedings (20 minutes on, 20 minutes off) will aid in reducing swelling and relieving pain
- Severe engorgement needs serious attention every feeding until it is improved. If left untreated, your milk supply may drop or subside altogether. Allowing the milk to sit in your breasts can lead to plugged ducts and or mastitis, a bacterial infection of the breasts.
If you are choosing not to breastfeed, your breasts don’t know that and will produce milk anyway. Talk to a licensed Lactation Consultant about the steps needed at that point to dry up your milk supply.
Copyright© 2011 Danielle Gauss/ JustBreastFeeding.com. All Rights Reserved.