Anything that reduces the amount of time your baby is at your breast or postpones regular nursing can cause overly full or engorged breasts. A breastfeeding mother usually feels a normal fullness (slight heaviness that is not painful) in her breasts, especially in the first couple of days when her milk comes in. But overly full or engorged breasts can be very painful and feel very hard. You also may have breast swelling, tenderness, warmth, redness, throbbing and flattening of the nipple.
Engorgement sometimes also causes a low-grade fever and can be confused with a breast infection. Engorgement is the result of the milk building up, and usually happens during the third to fifth day after birth. This slows circulation and when blood and lymph move through the breasts, fluid from the blood vessels can seep into the breast tissues. All of the following can contribute to engorgement:
- poor latch-on or positioning
- trying to limit feeding times or infrequent feedings
- giving supplementary bottles of water, juice, formula, or breast milk
- overusing a pacifier
- changing the breastfeeding schedule to return to work or school
- the baby changes the nursing pattern by beginning to sleep through the night or breastfeed more often during one part of the day and less often at other times
- having a baby that has a weak suck who is not able to nurse effectively
- fatigue, stress, or anemia in the mother
- an overabundant milk supply
- nipple damage
- breast abnormalities
Engorgement can lead to plugged ducts or a breast infection, so it is important to try to prevent it before this happens. If treated properly, engorgement should only usually last for one to two days.
- Minimize engorgement by making sure the baby is latched on and positioned correctly at the breast, and nurse frequently after birth. Allow the baby to nurse as long as he/she likes, as long as he/she is latched on well and sucking effectively. In the early days when your milk is coming in, you should awaken a sleepy baby every 2 to 3 hours to breastfeed. Breastfeeding often on the affected side helps to remove the milk, keep it moving freely, and prevent the breast from becoming overly full.
- Avoid supplementary bottles and overusing pacifiers.
- Try hand expressing or pumping a little milk to first soften the breast, areola, and nipple before breastfeeding, or massage the breast and apply heat.
- Cold compresses in between feedings can help ease pain. Some women use cabbage leaves to soothe engorgement. Although their effectiveness has not been proven, many women find them soothing. You can use either refrigerated or room temperature leaves. Make sure to cut a hole for your nipple, apply the leaves directly to your breasts, and wear them inside your bra. Remove them when they wilt and replace with fresh leaves.
- If you are returning to work, try to pump your milk on the same schedule that the baby breastfed at home.
- Get enough rest and proper nutrition and fluids.
- Also try to wear a well-fitting, supportive bra that is not too tight.
[ Learn basic breastfeeding techniques: Breastfeeding Know-How – Tips for Making it Work ]
IMPORTANT: If your engorgement lasts for more than 2 days even after treating it, contact your health care provider.
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