Breastfeeding is a beautiful journey a lot of mums embark on with their little ones. But it is not one without obstacles. One of the most common challenges mums face is breast engorgement.
Breast engorgement is characterised by swelling, tightness, and an increase in breast size. It usually happens between days 3 and 5 of breastfeeding, but it can happen as late as days 9 to 10.
Breast engorgement results from a buildup of fluid and blood in the breast. Early milk production can cause fullness in the breast, preventing fluid drainage and causing painful swelling.
Causes of Breast Engorgement
Certain conditions or events may increase your chances of experiencing the swollen fullness associated with breast engorgement. Among the causes of sore breasts after giving birth are:
- skipping a feeding
- skipping a pumping session
- producing an excess of milk to satisfy the baby’s appetite
- supplementing with formula in between nursing sessions, which may result in less nursing later on
- premature weaning
- caring for a sick baby
- latching and sucking difficulties
- not expressing breast milk when it first arrives if you do not intend to breastfeed
Breast Engorgement Symptoms
Each woman’s breast engorgement symptoms will be different. Engorged breasts, on the other hand, may feel:
- difficult or constrained
- soft or warm to the touch
- full or heavy
The swelling may be limited to one breast or it may affect both. Swelling can also spread up the breast and into the armpit.
The veins running beneath the skin of the breast may become more visible. This is caused by increased blood flow as well as skin tightness over the veins.
In the early days of milk production, some women with breast engorgement may experience a low-grade fever and fatigue. You can continue to nurse if you have this fever, which is also known as “milk fever.”
However, it’s a good idea to notify your doctor if you have an increased body temperature. It’s because some infections in the breast can also cause fever, and these infections must be treated before they become more serious.
Mastitis, for example, is an infection that causes inflammation of the breast tissue. It is most commonly caused by milk becoming trapped in the breast. Mastitis, if left untreated, can lead to complications such as a buildup of pus in the clogged milk ducts.
Inform your doctor about your fever and any other recent symptoms. They will want you to keep an eye out for signs of illness or infection so that you can seek immediate treatment.
How to Relieve Breast Engorgement
Are your breasts engorged after your baby’s birth? Treat breast engorgement with these 7 simple steps.
Get some heat on the breasts
Before each feeding, apply some warm, moist heat (with a warm cloth or compress) on the breasts for a few minutes, or take a short, warm shower if you are not practising strict confinement.
If showering, ensure that the water is hitting your back and not your breast. Warmth will help the milk to flow – but do not apply heat for more than five minutes, because it may make the swelling worse.
Wear a well-fitted nursing bra
Image source: iStock
Wear a well-fitted nursing bra for good support during this period. Ill-fitting bras could lead to mastitis. If you are not sure of your breast size, then opt to use a nursing tank. There are many nursing tanks and bras on the market that are recommended by breastfeeding mums.
Breastfeed your baby frequently
Allow your baby to breastfeed frequently, round the clock, as the infant suckling is the most effective mechanism for the removal of milk from the breasts.
Are you unable to pump your engorged breast? Try reverse pressure softening.
By redistributing the fluid behind the nipple, a type of breast massage known as reverse pressure softening can help bring out a nipple flattened by engorgement.
The fluid in the compacted area can be gently moved away from the nipple with your fingers, sending it temporarily deeper into the breast. This can assist a baby who is having difficulty latching on to a full breast and can also help to relieve the “traffic jam” behind the nipple.
Image source: iStock
Massage the breast, nipple and areola prior to and during milk expression to clear any blockage and enhance the flow of the milk.
How to Do a Breast Engorgement Massage
Begin by identifying your blocked areas on one side of your breast: Raise your left arm in the air and examine your left breast with your right hand, looking for knots, hard areas, and blocked ducts. Do the same for the opposing side.
Step 1: The lymph gland is the hard spot on your armpit. Begin by ‘pumping’ your lymph gland in your left or right armpit for 5 to 10 seconds by applying pressure and releasing it.
You can press with 2 to 4 fingers as long as you feel the pressure. You’ll feel a little sore, but that’s because you’re pressing in the right place.
Step 2: Begin by massaging in circular motions from the outside of your left breast to the inside of your left breast 5 to 10 times clockwise and counterclockwise.
Step 3: Apply pressure to the four meridian points located approximately 2 inches above, below, left, and right of the areola.
Step 4: Hold your breast with your left hand, apply pressure upwards, and stroke downwards from the top of the breast with your right palm.
Step 5: To push the milk into the ducts, use your thumb to apply more pressure by pushing downwards.
Step 6: Cup your hands around your breasts and move them up and down 3 to 4 times.
Step 7: Squeeze the tip of your areola a few times in all directions with your index and thumb until your milk drips. If using your index and thumb doesn’t work, try an outward pull motion with your five fingers.
5. Apply a cold pack or cold cabbage to the breast
Apply a cold pack (ice pack over a layer of clothing) or cold cabbage compress on the breast between feedings to help reduce swelling. 20 minutes on, 20 minutes off; repeat as needed.
It’s not clear why cabbage leaves help treat breast engorgement, but the green cabbage plant contains a high concentration of sulphur, which is known to reduce swelling and inflammation in all tissues.
How to Use Cabbage for Breast Engorgement
- Chill the cabbage for 15 minutes before using. The cabbage, like an ice pack, works best when it is cold.
- Remove the outermost layer of the cabbage and use the inner leaves. Keep the rest of the cabbage in the fridge for later use.
- Cabbage leaves should be thoroughly cleaned with running water to ensure there is no dirt residue.
- Dry the leaves with a clean cloth.
- Insert a leaf into your top, covering as much of your breasts as you can.
- Allow the leaf to sit for no more than 2 hours, or until it begins to feel warm. Remove the leaf as soon as you feel better if you want to breastfeed. If you leave the cabbage leaves on for too long, your milk supply may suffer.
- The used leaves cannot be reused and must be discarded immediately.
Try not to overdo it, and if you must, limit yourself to no more than two times per day.
Express milk before feeding
Image source: iStock
If your breast is uncomfortably full at the end of a feeding or between feedings, then express a bit of milk (by hand or with a pump) before feeding, so that the breasts do not become over
Apply a fenugreek seed (methi) poultice
Apply a fenugreek seed (methi) poultice. This is a traditionally practised custom in India to treat breast engorgement and mastitis.
Steep some fenugreek seeds in a cup of warm water. Let seeds cool, then mash them. Place on a clean cloth (handkerchief), warm it up and use it as a poultice on engorged breasts to help with let-down and sore spots. Do not apply for more than five minutes.
How to Prevent Breast Engorgement
Breast engorgement cannot be avoided in the first few days after giving birth. You may overproduce milk until your body learns how to regulate it.
However, the following tips and techniques can help you avoid future periods of breast engorgement:
Make sure your baby has a good latch
Sometimes, breast engorgement happens when your child is finding it difficult to latch on to one breast. To prevent this, find the best position where you and your infant are both at ease and she can get a proper latch and can suck the milk out without any issue.
A nursing pillow can make your breastfeeding journey comfortable for you and your baby. Read here to find out about the best nursing pillows in Singapore.
Regardless of the nursing schedule, your body produces milk on a regular basis. Nurse your baby every one to three hours at the very least. If your baby isn’t hungry or you’re away, use a breast pump or hand express to get the milk out.
Use ice packs to slow down your milk supply
Ice packs and cold compresses may help decrease milk supply in addition to cooling and calming inflamed breast tissue. This is because the cool packs suppress the “let down” signal in your breasts, which instructs your body to produce more milk.
Squeeze out small amounts of breast milk
If you need to relieve some of the pressure, you can express some breast milk by hand or pump a little. However, don’t over-pump or over-express. It could backfire, and your body may end up producing more milk to compensate for what you just removed.
Your weaning strategy may backfire if you are too quick to stop nursing. It’s possible that you’ll end up with too much milk. Wean your child gradually so that your body can adjust to the reduced need.
You can delay breast milk production if you do not breastfeed. Your body will realise it doesn’t need to produce milk in a matter of days, and the supply will dry up. This will put an end to the engorgement.
Don’t give in to the temptation to express or pump milk. You’ll be signalling to your body that it needs to produce milk, which may cause discomfort.
If the engorgement does not go away in three to four days or if you develop a fever, contact your doctor. They’ll ask you to keep an eye out for any other symptoms that could indicate a more serious problem, such as a breast infection.
Image source: iStock
Updates by Matt Doctor
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