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Engorgement

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Engorgement

It is normal for your breasts to feel full when your milk comes in. Full breasts may feel larger and firm but not hard, and milk will drip or flow freely when you express by hand. This is often called a “let-down.” Breast fullness is normal and is a good sign; your milk supply will soon be regulated by your baby’s feeding. Breast engorgement is different and needs attention.

Engorgement generally occurs around the third day after birth, or when your milk comes in. When the breasts are engorged the little muscles inside the breast tissue can’t contract as easily and the milk doesn’t drip or flow freely.

Signs of Engorgement:

  • Your breasts will be overfull, painful, hard and hot
  • Your nipple may look much flatter than it usually does
  • Your breasts may look shiny and tight
  • You may feel hot and have a slight increase in temperature
  • Your baby may be having trouble latching deeply on to the breast
  • Your baby may fuss at the breast and you may not be able to hear him swallowing
  • You will not be able to express your milk freely


Managing engorgement:

  • Make sure you have a comfortably fitting bra and clothing
  • Avoid the use of heat – it may increase the engorgement. Avoid very hot showers
  • Don’t massage or try to stimulate the breasts while they are engorged
  • Use gentle hand expression to soften the areola (coloured part) and help “let-down”
  • Try different feeding positions – (cradle and football) to drain all areas well
  • Ensure the baby is latched on well, and the feed is not causing nipple pain
  • Allow the other breast to drip whilst breastfeeding
  • After feeding use cold compresses or ice packs (on the breasts but never on the nipple)
  • Try cabbage leaves, but use cautiously as this may reduce your supply if used for too long
  • Ask your midwife about analgesia and anti-inflammatory medication
  • Ask your midwife if you need further assistance.


Prevention:

Early first breastfeed followed by frequent feeding to baby’s cues or as indicated specifically for your baby.

 

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