What causes breast engorgement and how can it be managed?
Breast engorgement commonly occurs during the first few days after birth, when milk first comes into the breast. When this happens, more blood and fluid flows to the breast and surrounding area causing them to swell. Most women will experience a mild to moderate feeling of breast warmth and heaviness during this process, which is completely normal. However, some women experience true engorgement and find that their breasts have grown rather large, hard, warm, painful, and even lumpy to the touch.
Fortunately, a few days after your milk comes in, your milk supply should naturally adjust to fit your baby’s needs. You can expect relief from the first “normal” engorgement within 24 hours (or a few days if you are not breastfeeding). If these symptoms do not disappear within a few days, or if your breasts do not soften after feeding – home treatment should be initiated.
If you should find that home treatment is necessary – keep in mind that engorgement is very normal and is actually a positive sign. Engorgement simply means that your breasts are realizing their intended purpose and are producing milk to feed your child. And once you get through the initial engorgement, you’ll be able to fully enjoy the unique bond that can be shared between you and your baby. Below are a few tips to help along the way:
- Nurse frequently (every two to three hours) – even if you must wake your baby. This is important because unrelieved breast engorgement can cause a permanent reduction in milk production. Try to get one side as soft as possible. If your baby is satisfied after the first breast, you can offer the other at the next feeding.
- Wear a supportive nursing bra, even at night. However, make sure it isn’t too tight.
- Avoid pumping milk except when you must soften the areola (the dark area around your nipple) or when your baby is unable to latch. Excessive pumping of milk will lead to an overproduction of milk and continual issues with engorgement.
- Avoid having your baby latch when the areola is very hard or firm. To reduce the potential for nipple damage, and to help your baby latch – manually express or pump milk until the areola becomes soft. It might be easier to manually express milk in the shower as the warm water may cause enough leakage to soften the areola.
- To reduce pain and swelling, take ibuprofen or acetaminophen, in accordance with your healthcare provider’s advice.
- If your breasts are still uncomfortable after feeding, apply a cool compress for a short period of time. When used in conjunction with a cool compress, refrigerated Little Stinker™ Cooling Breast Cream will provide additional cooling benefits.
- If you are not breast-feeding, avoid stimulating the nipples and do not apply heat to the breasts – unless it is only to help soften the areola. Heating of the breast may make the condition worse.
- The application of fresh cabbage leaves to the breast has been used traditionally to help relieve discomfort associated with breast engorgement. To do this, strip the main vein from two large, outer leaves and cut a hole in each one for your nipple. Rinse and dry them before placing them on your breasts or into the cups of your bra. As an alternative, the Little Stinker Cooling Breast Cream has been formulated with a high concentration of cabbage leaf extract, which can be gently massaged into each breast.