If you have ever had engorgement while breastfeeding, you know that it can be very uncomfortable and no fun to deal with. The good thing is there are a lot of things you can do to help with engorgement and to even help decrease the discomfort.
What is engorgement?
When your milk “comes in” about 2 to 5 days after birth it is normal for your breasts to feel warm, full, heavy, and warm. This is caused by the swelling and increased fluids in your breast as your body begins making breastmilk.
The normal fullness can turn into engorgement if your baby isn’t nursing enough or for some reason your breasts are not being emptied (for example, you are not around your baby and you are not pumping). If this isn’t relieved, your breasts can become hard, painful, and you may even develop a fever.
Signs and symptoms of engorgement
There are many signs and symptoms of engorgement, and it is best if you start treating engorgement as soon as possible to help decrease the symptoms and severity.
- Your breasts may feel hard, warm, and tender. The skin of your breast may also be shiny and taught. The swelling can extend into the the armpit and you may even experience arm tingling from the pressure on your nerves.
- The areola may feel hard like the tip of your nose. Your nipple may also become flat, making latching on very difficult.
- You may also have a low grade fever.
- Engorgement can happen at different times of the day and can happen in one breast at a time.
- Engorgement that is not treated can lead to plugged ducts and mastitis.
Can I prevent engorgement?
Preventing engorgement is somewhat possible, you just have to be prepared and follow several tips.
- Nurse often, the more you nurse, the more your breasts will be emptied. During the first few days you should nurse 10-12 times per day. Over time your body will adjust to what your baby needs.
- Switch which side you offer first, and make sure baby is emptying the first breast before you offer the second. For example, offer the right the first feeding, and when she is finished, offer the left. No matter if she empties the left or not, offer the left breast first at the next feeding.
- Never limit the time your baby spends at the breast. Some people say to limit time to 10 minutes each side, but each breast is different. Your baby may be able to empty one side in 5 minutes, while it takes her 15 minutes for the other side. Take cues from your baby, as long as she is still sucking and swallowing, she can stay at the breast.
- Make sure your infant is latching on correctly to help empty the breast sufficiently.
- If your baby is not nursing well for some reason, make sure you are expressing your milk to help prevent engorgement. You can either hand express or use a breastpump.
What if I am already engorged?
If you are already engorged it is obviously too late to prevent engorgement, but relief can be just around the corner. Many of the things you do to prevent engorgement will also treat it, though you may have to make a few adjustments.
- Breastfeed often, just like when you are trying to prevent engorgement, the best way to treat it is to breastfeed often. This will help increase the amount of milk that is emptied from your breast.
- Ensure your baby has a proper latch so she can empty your breast effectively. This can be difficult if your nipples are tight and flat. If your baby latches on, it may help to remove your baby and relatch after a few minutes and once your breast has softened up a little. This can improve the latch.
- Nursing your baby in just a diaper can help stimulate sucking (skin to skin contact).
- You may need to pump or express some prior to breastfeeding. This will help encourage your nipples to soften to make it easier for your baby to latch on. You can either hand express, pump with a breast pump on a low setting, or use reverse pressure softening to help.
- Cool compresses up to 20 minutes before breastfeeding can help with the swelling and pain.
- Moist warm compresses a few minutes prior to feeding can help milk begin to flow, though you should only do this for a a couple of minutes as it can make swelling worse if used for a prolonged period of time.
- While nursing you can gently massage the breast to help remove milk. Try to focus on areas where you can tell the milk tends to collect, such as a specific duct if you notice one spot that is harder than another.
- If your breasts still feel full after a feeding, it can help to pump to remove the excess milk.
- Cabbage leaves can help with the pain and swelling. Just place a cabbage leaf in your bra over your breast. The downside to this is you will smell like cabbage, but make sure you are changing out the leaves when they start to smell.
- Make sure you are wearing a well fitting bra. While you are breastfeeding you may need to increase the size of your bra by several cup sizes in some cases.
- If the pain is very bad, you can take acetaminophen or ibuprofen.
- DO NOT restrict your fluids because this does not help with engorgement.
If you cannot get your baby to latch, your baby is not making enough wet and dirty diapers, you have a temperature over 100.6 degrees F, or engorgement is not relieved by any of these measures, you should contact your lactation consultant or healthcare provider. If you have additional questions, you can contact your local Le Leche League at any time for additional support.
Engorgement usually only lasts about 24 to 48 hours, so hang in there, it will get better.
Have you ever had to deal with engorgement? What did you do to get relief?