Postpartum Breast Engorgement
Breast engorgement usually occurs 2-3 days after delivery. This is perfectly normal and is attributed to the milk “coming in”. Up until this time the breasts produced colostrum, highly concentrated first milk but the your breasts probably did not feel “full.” The body is amazing in that it intuitively determines how much milk the baby needs and produces just enough, but the milk often comes in heavy and fast in the beginning.
When the mature milk is produced breasts may become overly full and engorgement may occur. It can be downright painful! Luckily if treated, engorgement usually only lasts a few days. However, be careful – unrelieved engorgement can lead to breast infection.
Breast engorgement can actually occur anytime your breasts create more milk than your baby can consume.
In most cases, a newborn baby will take care of this early engorgement by feeding frequently. The baby is getting the first taste of full milk rather than colostrum and needs the nutrients in the early days of growth. You may think that your days of engorgement are over, but that’s not always the case.
Symptoms of Engorgement
Any time that a woman’s breasts overproduce milk or the baby fails to keep up with production, the breasts can become too full. You may notice one or more of the following signs of engorgement when this occurs:
- Breast swelling
- Breast tenderness or pain
- Firm or hard breasts
- Lumpy texture to breasts
- Warm sensation on breasts
- Flattened areolas
- Firm areolas
- Tenderness in underarm lymph nodes
- Mild fever
While these symptoms are uncomfortable, they can also make breastfeeding more difficult. Your baby may struggle to latch onto the breast properly, which makes it even harder to alleviate the problem through a good feeding session. This is why it’s important to know how to overcome engorgement as quickly as possible.
How to Treat Breast Engorgement
In some cases, eliminating breast engorgement is as simple as breastfeeding your baby or pumping out some of the milk. You may also express some of the milk by hand if you don’t have a pump handy and need fast relief. This may not be enough when you’re suffering from long-term engorgement due to interruptions to your breastfeeding routine or changes in your baby’s feeding habits.
1. Rethink your breastfeeding habits.
You may need to stop trying to feed on a schedule and allow your baby to feed on demand, allowing your body to sync naturally with your baby’s needs. Also check that your baby is latching onto your breast properly and isn’t having other problems while feeding. If your baby seems to latch okay but unlatches and cries a lot during feedings, you may have other problems that you need to fix with a doctor and/or lactation consultant.
Pay attention to the positions that you’re using for breastfeeding and the length of time that you give your baby to feed. Are you relaxing and enjoying the time, or are you stressed and uptight because you have so much to get done during the day? Is your baby so warm and comfortable that he or she falls asleep at the breast? Switching to an upright hold or stripping your baby down to his or her diaper may help with alertness so that feeding sessions last longer, properly depleting your breasts of milk.
2. Ask your doctor if it’s safe to take ibuprofen.
In most cases, this is a safe over-the-counter medication to reduce inflammation in the breast. This can help relieve swelling, softening your breasts so that your baby doesn’t struggle to latch properly. It’s not a fast or full-proof solution, but it can help relieve your discomfort while possibly helping your baby breastfeed easier to solve the issue.
3. Apply a warm, wet compress or take a warm shower.
Warm water or a moist compress can soften your breasts enough to allow your baby to latch properly or to make pumping easier and less painful. This is something that you can do just before a breastfeeding or pumping session, and you may still want to release some milk with your fingers before placing your baby to the nipple.
This is also something that you can do to simply relieve some of the pain and swelling for your own comfort. Just make the shower brief because anything over five minutes may actually increase the swelling.
4. Apply a cold compress after breastfeeding sessions.
Once your breasts are fully emptied through breastfeeding and perhaps the assistance of a good pump, you may still notice some tenderness and perhaps a bit of swelling in your breast tissue. This is when a cold compress placed across your breasts and nipples can help.
5. Gently massage your breasts to help relieve swelling and expel some of the milk.
If you find it difficult to pump and your baby isn’t latching easily, try to calm yourself and get into a comfortable position rather than stressing out. Free your breasts from your bra if you’re wearing one, and start to gently massage both breasts in a circular motion.
This may help release some of the milk if you try expressing, and it can soften the breasts a little. If you have a partner who wants to help, allow them to gently do the massaging between feedings to help prevent engorgement as your breasts refill for the next feeding.
6. Check for signs of infection.
Luckily breast engorgement is usually short lived and can be resolved fairly quickly. However, if engorgement has not cleared up nor has not much improved, you will want to contact your health care provider…especially if you experience any flu-like symptoms, fever, extreme soreness or pain, hardness or redness. In fact. if the ducts in your nipples seem clogged, you spike a fever higher than 101° Fahrenheit, or your breasts appear extremely red and feel hot to the touch, this could be a sign of mastitis or breast infection and should be treated right away. Call your doctor for instructions or just go to the emergency room or urgent care to make sure there isn’t something more urgent happening.
7. Consider a cream designed to dry up breast milk, but use this carefully and only as a last resort.
When all else fails, you may be tempted to try something like Cabo Crème. This is a nipple cream that contains concentrated cabbage extract, which meets the needs of women who want to quickly dry up their milk supply because they’re no longer breastfeeding. It is also marketed as a solution for engorgement, but keep in mind that it can dry your milk supply up in a matter of days if you use too much or use it too often. This is a last resort if you choose to go this route at all.
How to Avoid Breast Engorgement
The best way to treat and prevent engorgement is frequent nursing. Luckily, most babies are more than willing to oblige. Nurse your baby often, approximately 8-12 times in a 24 hour period, especially in the first few days. Make sure breasts are completely emptied and that the baby is positioned and latched on correctly. A lactation consultant can help to assure your baby is feeding correctly.
In some cases, avoiding engorgement isn’t possible, but it doesn’t hurt to know what you can do to prevent the problem when it is possible. This may stop you from making simple mistakes that cost you a lot of pain and suffering.
Here are some tips that will really help:
- Allow your baby to breastfeed whenever he or she demands nourishment. You may try to stick to a schedule to add some routine into your day, but never get so caught up with a routine that you neglect the needs of your baby and your breasts. Breastfeeding frequency is an important factor that tells your body how much milk your baby needs, and allowing your baby to communicate that to your body is the most natural way to keep the right amount of milk flowing through your breasts.
- Invest in a high-quality breast pump. If your baby struggles to latch onto your nipple because they’re too hard and swollen, you can fix the problem by expressing a bit of milk to soften them just before allowing your baby to latch. You may also need to pump and store your milk if your baby temporarily stops feeding frequently or your schedule restricts you from breastfeeding on demand for a period of time. Not only does pumping help prevent engorgement, but it continues to send signals to your body that milk is in high demand just as if your baby were feeding more frequently.
- Make sure your breasts are completely emptied at each feeding. If your baby doesn’t naturally do this, you can use a pump to finish the job. This gives you more time to allow the milk to collect between feedings before discomfort may set in.
- Avoid pacifiers and other fake nipples. While it’s convenient to keep your baby occupied for longer periods of time so that you can get other things done, it reduces the amount of time that your baby spends at the breast. If you use bottles, there’s a chance that your baby will start to prefer the bottle to your breast, forcing you to wean early or endure ongoing engorgement and frequent pumping.
- Pick up on the early signs of engorgement. If you can use your pump or express some milk by hand before the engorgement gets severe, you can prevent the discomfort altogether. The pain comes when a lot of milk collects in the breast, so releasing some of the milk before it gets out of hand often works.
- Make sure to wear a comfortable nursing bra and avoid bra’s that contain under wire.
While using a breast pump to keep your milk supply strong is often a good idea, it is possible to start producing too much milk if your body believes that your baby needs far more milk than he or she can actually consume. You will eventually end up with engorged breasts or a freezer full of more milk than you will ever use.
Try to avoid this by finding a balance, sending just the right signals to keep your baby in a consistent supply of much-needed milk. You can always back away from pumping and allow your baby to send the cues naturally if you think your engorgement is due to pumping too aggressively.