Engorged breasts

During the first few weeks after delivery as the colostrum "starter milk" is changing to mature milk, your breasts will become full. This normal postpartum fullness usually diminishes within 3-5 days. Engorgement can occur if your baby does not adequately remove milk from your breasts. This causes your breasts to feel hard, painful and hot. This is due in part to extra blood and swollen lymph nodes, not entirely to accumulated milk. Excessive fullness of the breasts can also lead to swollen areolas (the dark area around the nipple) and flattened nipples making it difficult for the baby to latch-on, causing sore nipples.

You can prevent engorgement by following these simple guidelines: Breastfeed your baby frequently, 8-12 times in 24 hours. Unless it's recommended by your health care provider, avoid supplements of water or formula for the first 3-4 weeks. If you miss any feedings, express your milk, and when weaning your baby, do so gradually.

Engorged breasts can be treated in several ways. Try applying hot, moist towels to your breasts for a few minutes, or taking a hot shower before feeding your baby. After using moist heat, hand-expression of milk will help soften the areola, making it easier for the baby to latch-on to your breast. You may also want to use gentle massage, deep breathing, soft music or other relaxation techniques before and during nursing. Icy cold compresses applied to your breasts can relieve discomfort and swelling after breastfeeding.

If your baby takes only one breast, you can alleviate engorgement of the breast that you are not using to feed by using a breastpump or by hand expressing milk. If your baby can not latch-on or your nipples are flattened, use a hospital-type electric breastpump or hand expression to soften the areola. Use moist heat and breast massage before pumping. Continue pumping every two hours, 10 minutes per breast, until your baby can latch-on.

Avoid bottles, pacifiers and nipple shields. These may cause nipple confusion or preference for your baby.

Wearing a proper fitting, supporting nursing bra will make full breasts more comfortable and prevent the discomfort of engorgement.

If you have further problems, contact your health care professional or breastfeeding specialist.

Once you have stopped breastfeeding completely your breasts will stop making milk relatively quickly. As a result, your breasts may become engorged. Ease the discomfort by:

• Expressing milk either manually or with a pump.
• Taking a hot shower or putting a warm compress on your breasts.
• Gently massaging your breasts from under the arm and down the nipple.
• Take the occasional non-aspirin pain reliever. Just remember to refrain from taking any medications without first consulting your doctor.

If you have extreme engorgement, heat will not relieve discomfort but may actually further aggravate the situation. If this is the case, try using a cold compress or cool water as you express milk. Some women find it works to alternate cold and warm water. Whatever your method, engorgement should subside (along with the pain) in a few days.