Engorgement is such an ever present postpartum hurdle to endure when you make the important decision to nurse your baby in order to provide breast milk as their sole source of nutrition.
It is a feeling you can't quite describe until you endure it, and then it becomes a feeling you quickly wish to never have to experience again... ouch!
If you are new to the breastfeeding world and have a newborn you're learning to nurse - it is likely that you have heard, read or seen somewhere that colostrum is the first source of nutrition your baby will receive once breastfeeding is initiated after birth.
It is chalked full of nutrients at a higher density level than what your mature milk will consist of as breastfeeding continues and your milk becomes composed of what your baby tells your body to provide.
For the first 24-72 hours after you give birth, colostrum is produced in small amounts but is as previously mentioned, high in nutritional content. As demonstrated below, our bodies are brilliant in knowing that CONTENT is more important than VOLUME since your babies belly is only the size of a cherry for the first few days. Remembering this and knowing prior to birth that your body can provide everything your baby needs without it being told to by any source other than your hormones themselves should be extremely satisfying and comforting to you.
After you work hard to provide adequate stimulation to your breasts by offering baby nursing sessions as much as he or she wishes - your body will kick into overdrive and tends to bring in your mature milk supply with a vengeance. Its exciting because, you and baby are the ones who made that happen! But engorgement can make it feel not so exciting as you muddle through postpartum hormones, learning your baby and their needs and now, suddenly feeling constant fullness to the point of constant discomfort. This of course, WILL begin to regulate as you and your baby train your body to produce the exact amount of milk needed for each feeding.
However, this takes time.
Mature milk usually comes in between 2 and 5 days postpartum - dependent on some factors personal to your labor, delivery and general physical health.
It is important to remember that if you experience complications with pre eclampsia or a prolonged labor or induction, you are going to have to work towards relieving engorgement moreso than a mama who is faced with neither of these factors. Both of these situations automatically cause your body to retain more fluid due to your bodies protective nature in retaining these fluids until it is told to do otherwise. Unfortunately, diuresing or ridding your body of these fluids takes time and can take a few days to a few weeks to complete its' process.
And even so, regardless of having dealt with either of those two factors, a mother's body is protective of the nursling it knows it needs to provide for, therefore - it is safe to say that engorgement is inevitable.
The positive though??
IT IS TREATABLE.
And that's why I'm here to tell you some ways to manage it, treat it and rid yourself of the discomfort it causes so you can continue to feel successful, empowered and excited to continue your nursing journey for the sake of you and your baby.
Engorgement is literally the swollen nature of the milk glands that live directly underneath your tissue and skin surrounding your breasts. Milk glands function primarily as sweat glands within our body and when they are told to go into "overdrive" and secrete as much fluid (AKA milk) as possible, they become swollen and enlarged when they are not used to being utilized as much as they are now.
As you can see from the above picture, it causes the breast as a whole to become enlarged - including your nipple and areola, which can complicate your baby's ability to latch on and successfully feed. Understandably so, your baby feeding and removing milk from these glands is the primary way in which engorgement can be relieved - so it is important you remember some tactics and techniques to pull out of your "back pocket" (of your postpartum sweat pants of course ;-) ) to use when desperate times call for desperate measures!
I would say one of the most common questions I receive from a postpartum mama is - "if I am this uncomfortable, can I please just pump?!"
And the short answer is: NO!
Or at least if it is at all avoidable. Pumping is only going to increase stimulation and signals sent to your brain to continue to produce more from simply causing more hormones to be released indicating milk supply needs to increase. If there is any reason in which you should need to pump in direct regards to this topic of conversation: pumping with an electric pump would merely only be allowable in order to relieve enough pressure to feel as though things are tolerable until baby can remove some further via a feeding.
Many lactation consultants and those who have breastfeeding experience and education (including myself!) will advise you to stray as far away from pumping with an electric breast pump for the first four weeks of your baby's life. The only caveat to this statement would of course be if you are being advised to do so by your child's pediatrician for the sake of increasing supply for weight loss needs (which would clearly mean you are likely not experiencing engorgement if you are needing to increase your supply).
Your baby's mouth is the best indicator to your body of how much or how little he or she needs. Their sucking strength, mouth movements and frequency in stimulating your breast are brilliant ways in providing the information your brain needs to understand just how much milk is needed. No machine can do quite what your baby can in establishing the perfect and unique milk supply your baby needs to have a good and sustained breastfeeding journey.
Instead, try the following to relieve and solve the discomfort you are enduring:
1) Haakaa Pump
- The Haakaa pump is an up and coming resource that moms all over the nation are finding to be their "breast friend" in the first weeks of their babys life. This is a manual, silicone pump that you can simply squeeze to apply suction as you put it on your breast. You use this on the breast opposite of what you are feeding your baby on during a feeding. This allows a natural release of milk that is built up in your breast to be released as a result of your let down reflex and gentle suction/traction pulling the milk out of your breast. It is just enough suction to relieve your breast of the pressure you don't want to remain in your breast without causing for too much stimulation via an electric pump. This is especially helpful if your baby is only able to empty one breast at a time in the early days of their life. The cute flower apparatus is a stopper so you can safely store the milk in the refrigerator until you decide when you want to use or store that milk. It comes with the Haakaa when you order it from somewhere such as Amazon, for a mere and affordable $12!
- These two are invaluable resources, and cheap ones too! But - lets make sure you use them in the right order for them to be most beneficial to you. So: HEAT for 15-20 minutes before feedings is going to allow that milk to be released from high up in your breast and milk glands so that it is readily available and easily removed from your breast by your baby's mouth and suckling motion. Moist heat is even better so try to have a washcloth handy to wet with water warmed to your skin's toleration level. Or- if time allows, jumping in the shower is better... just remember to only allow the water to flow on your back between your shoulder blades. Turning directly towards the water can actually stimulate that supply to come in faster and fuller which is the last thing we want at this time! And then afterwards, ICE to relieve discomfort, soreness and to remind your body it can slow down for the time being.
--->
These Lansinoh hot or cold breast therapy rings are some of my favorite to utilize when you are switching between the two temperatures for different parts of engorgement therapy. They easily fit in your nursing or sports bra so you don't have a bag of peas shoved in your bra or a heating pad streaming out of your shirt - which although resourceful and helpful, isn't always doable as you cart around that sweet bundle of baby you have to take care of too ;-)
*Found at Target, Walmart,
drug food stores & Amazon for $10* --->
3) Massage and reverse pressure softening
- Massaging your breast while laying flat (to allow gravity to do its work) is extremely helpful in removing that built up pressure and fluid. The massaging should be performed starting nearest your chest wall and allowing for movement forward towards your nipple so that it has an exit and way out. You can do this during the time you are utilizing heat and just before you begin to feed. Similarly, massaging during the feeding if possible can continue to encourage that fluid to move down and out.
- Reverse pressure softening is gentle but firm pressure with your index and middle finger approximately 1-2in from your nipple. You alternate placing your fingers on the sides of your nipple and then on the top and bottom of your nipple. Placing this pressure for approximately 60 seconds in a downward motion towards your chest wall will allow the edema/swelling to move away from your nipple so that your baby may more easily latch and be able to assist you in removing the milk in your breasts.
- It is important to offer your breast to your baby whenever baby tells you its time! Cue based feeding is highly encouraged in general for breastfeeding success long term. As a society, we become so focused on "routine" and predictability of what is to come next. The thing you will learn as a mom and parent is : baby's change things up constantly, its the name of their game! The more you can accept that and learn to adapt to it, the more successful this will be and the less stress you will endure. If he or she is desiring to eat frequently at the beginning: let them. It will work towards removing the milk needed to improve engorgement. In addition, skin to skin as frequently as is doable for you and baby keeps them alert and willing to continue to try to aid you in fixing and reversing this temporary problem!
- Tylenol/Ibuprofen when needed
- Wearing a nursing or sports bra that binds your breasts close to your chest at all times
- Hydration to the point of quenching thirst- do not OVER or UNDER hydrate, neither are helpful
- Cabbage leaves - this is for comfort only and should only be done for short amounts of time as it can actually have the reverse effect and dry up the supply you're working so hard to establish and maintain. However, can be helpful at the beginning with excessive discomfort
- TIME, time and more TIME. It WILL get better mama- but patience is truly a virtue
Should you begin to experience:
- A hardened, painful and red area on your breast
- A fever of 101 or greater
- Body aches and/or chills
But above all-
Stay encouraged mama. Reach out to me or someone you know who can help with breastfeeding needs. And know your discomfort is not in vain and that though your baby can't say it - he/she appreciates the hard work you are doing to make breastfeeding an important part in providing for baby and giving you satisfaction in doing the most naturally amazing thing to provide for your baby!
References upon Request
Kellymom.com "Engorgement Help" and La Leche League "Engorgement" of primary utilization for information within this post
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