Engorgement is when your breasts swell dramatically and seem filled to bursting, most often when your milk becomes more plentiful during the first and/or second week after birth. This might make nursing on the affected breast more painful when the baby first latches on due to swelling. Usually the fullness/swelling subsides within 12-48 hours as your body adjusts and your baby drinks from your breast. “You can prevent or minimize the effects of engorgement by:
- Nursing early and often. Nurse as soon after the birth as possible, and at least ten times a day after that.
- Ensuring that your baby is positioned well and is latched on properly (click here for instructions).
- Nursing "on cue". If your baby sleeps more than two to three hours during the day or four hours at night, wake him to nurse.
- Allowing baby to finish the first breast before switching sides. This means to wait until baby falls asleep or comes off the breast on his own.
- If your baby is not nursing at all, or is not nursing well, hand expressing or pumping your milk as frequently as baby would nurse.”
If this doesn’t relieve your symptoms, you can try:
- Warm compresses: “apply a warm, moist compress and expressing some milk just before feedings. Using heat for too long will increase swelling and inflammation, so it is best to keep it brief. Cold compresses can be used between to reduce swelling and relieve pain.” Source: La Leche League International, http://www.llli.org/faq/engorgement.html
- Breast massage: “with the palm of your hand and starting from the top of your chest (just below your collar bone), gently stroke the breast downward in a circular motion, toward the nipple. This may be more effective when done while you are in the shower or while leaning over a basin of warm water and splashing water over your breasts.” Source: La Leche League International, http://www.llli.org/faq/engorgement.html
- Areola massage: with your fingers positions as shown below, press inward toward the chest wall and count slowly to 50. Pressure should be steady and firm, and gentle enough to avoid pain.
Source: K. Jean Cotterman, http://www.nbci.ca/index.php?option=com_content&view=article&id=83:engorgement&catid=5:information&Itemid=17
Cabbage compress: “rinse the inner leaves of a head of cabbage, remove the hard vein, and crush with a rolling pin (or similar). They can be used refrigerated or at room temperature. Drape leaves directly over breasts, inside the bra. Change when the leaves become wilted, or every two hours. Discontinue use if rash or other signs of allergy occur. Some reports suggest that overuse of cabbage compresses can reduce milk production, therefore discontinue the compresses when the swelling goes down.” Source: La Leche League International, http://www.llli.org/faq/engorgement.html
Contact your doctor if your symptoms do not improve after trying the above relief methods, if you have symptoms of mastitis (fever of more than 38.1°C), if your baby is unable to latch or if he does not have enough dirty diapers.