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Understanding and Managing Breast Engorgement – A Comprehensive Guide

June 6, 2023

Mother in pain breastfeeding her baby

Breastfeeding engorgement can be an overwhelming and uncomfortable experience for breastfeeding mothers. The swelling, pain, and tenderness in the breasts can make nursing a challenging and distressing process. You can understand and manage breast engorgement. Knowing how to do it with the right strategies can make breastfeeding more comfortable and successful.


Understanding breast engorgement is essential for any breastfeeding mother. By comprehending the underlying factors that contribute to engorgement, you can better anticipate and prepare for its occurrence. We will unravel the reasons behind breast engorgement, including increased blood flow, hormonal changes, and inadequate milk removal. Furthermore, we will shed light on the symptoms of breast engorgement, such as swollen and painful breasts, nipple flattening, and discomfort.

Lastly, we will debunk common myths and misconceptions surrounding breast engorgement. By dispelling these misunderstandings, we aim to provide accurate information that empowers you to make informed decisions about your breastfeeding journey.

What is breastfeeding engorgement?

Breastfeeding engorgement refers to the condition where a breastfeeding mother’s breasts become overly full and swollen due to an accumulation of milk. It typically occurs within the first few days after childbirth, as the body adjusts to the demands of breastfeeding. Engorgement happens when there is an imbalance between milk production and milk removal from the breasts.

Understanding Breastfeeding Engorgement

Mother at hospital feeding newborn breast milk, newborn holding mothers finger
Mother at hospital feeding newborn breast milk, newborn holding mothers finger

Causes of breastfeeding engorgement

1. Increased blood flow and milk production

During pregnancy, hormonal changes stimulate blood flow to the breasts, preparing them for milk production. After childbirth, the hormones prolactin and oxytocin continue to regulate milk production and release. If you don’t take out enough milk, your breasts can become swollen. This happens because you might have more blood flow and make more milk.

2. Milk not properly removed from the breasts

Proper latch and effective breastfeeding are crucial for ensuring optimal milk removal. If the baby does not latch properly or is not feeding frequently enough, the milk may accumulate in the breasts, causing engorgement. It is essential to establish a deep latch to ensure efficient milk transfer.

3. Hormonal changes

Hormonal fluctuations during the early postpartum period can contribute to breast engorgement. These hormonal shifts may cause temporary fluid retention and increased blood flow to the breasts, leading to swelling and engorgement.

4. Delayed or Skipped Feedings

Delaying or skipping breastfeeding sessions can disrupt the balance between milk production and removal. It can result in milk buildup and engorgement. Maintaining a regular feeding schedule is essential for preventing engorgement.

B. Symptoms of breastfeeding engorgement

1. Firm, swollen breasts

Engorgement causes the breasts to become swollen, firm, and noticeably larger than usual. The increased milk production and accumulation contribute to the fullness and tightness of the breasts.

2. Pain and discomfort

Breast engorgement often leads to pain and discomfort in the breasts. The pressure from the excessive milk buildup can cause aching, throbbing, or a feeling of heaviness. The breasts may also become tender and sensitive to touch.

3. Nipple flattening or inversion

Engorgement can affect the appearance and sensation of the nipples. The nipples may flatten or become inverted, making it more challenging for the baby to latch properly. Engorgement can also cause the nipples to feel sensitive, making breastfeeding more uncomfortable.

4. Skin Changes

The skin over the engorged breasts may appear shiny, stretched, or tight. The increased blood flow and swelling can cause the skin to take on a reddish or flushed appearance.

5. General Malaise

Some women may experience accompanying symptoms such as fatigue, fever, or flu-like symptoms. These symptoms can indicate the presence of mastitis, a condition where the engorgement progresses to an infection. Seeking medical attention is crucial if these symptoms occur.

Prevention of Breastfeeding Engorgement

breast feeding baby
breast feeding baby

A. Proper latch and positioning techniques

  • Ensuring a proper latch is crucial for effective milk transfer and preventing engorgement. Seek guidance from a lactation consultant or healthcare professional to learn proper latch techniques.
  • Positioning the baby correctly during breastfeeding can also help ensure efficient milk removal. Optimal positioning helps the baby latch deeply, allowing for effective milk extraction.

B. Frequent and effective breastfeeding

  • Establishing a regular breastfeeding schedule promotes regular milk removal, preventing milk buildup and engorgement.
  • Encourage frequent breastfeeding, especially during the first few weeks after birth when establishing the milk supply. Aim for at least 8 to 12 breastfeeding sessions within 24 hours.
  • Encourage the baby to empty one breast fully before switching to the other. This helps ensure adequate milk removal from each breast.

C. Avoiding long gaps between feedings

  • It is important to avoid long periods between breastfeeding sessions. If the baby sleeps for an extended period, gently wake them for feeding to maintain milk removal and prevent engorgement.
  • If breastfeeding is not possible, use a breast pump to maintain milk supply.

Managing Breastfeeding Engorgement

A. Cold and warm compresses

  • Apply cold compresses, such as ice packs or chilled cabbage leaves, to the breasts for 15 to 20 minutes after breastfeeding. Cold temperatures can help reduce swelling and discomfort.
  • Apply warm compresses, like warm towels or warm water in a basin, before breastfeeding to promote milk flow and relieve engorgement.

B. Breast massage and hand expression

  • Gently massage the breasts before and during breastfeeding to stimulate milk flow and aid in milk removal. Start from the chest wall and move towards the nipple in a circular motion.
  • Use your fingertips to apply gentle pressure, but avoid pressing too hard as it may cause additional discomfort.

C. Supportive Bras and Clothing

  • Wear a well-fitting, supportive bra that does not constrict the breasts or put pressure on engorged areas. A supportive bra can help alleviate discomfort and provide some relief.
  • Opt for loose-fitting clothing to avoid additional pressure on the breasts.

Seeking Support and Professional Help

A. Contacting a lactation consultant

  • If engorgement persists or becomes severe, seek guidance from a lactation consultant or healthcare professional. They can provide personalized advice and support tailored to your specific situation.
  • A lactation consultant can assess your breastfeeding technique, provide tips for effective milk removal, and offer additional strategies to manage engorgement.

B. Support groups and online communities

Managing engorgement can be physically and emotionally taxing. Connecting with a lactation consultant, or healthcare professional, or joining a breastfeeding support group can provide a much-needed source of emotional support. Sharing experiences, concerns, and frustrations with others who have been through similar situations can help alleviate stress and anxiety.

Common Myths and Misconceptions about Breastfeeding Engorgement

Myth 1: Breastfeeding engorgement is a sign of having too much milk.

Fact: Breastfeeding engorgement is not necessarily an indication of having an oversupply of milk. Engorgement can occur due to various factors, including hormonal changes, inadequate milk removal, or delayed feedings. It is a temporary condition that usually resolves as the milk supply and breastfeeding routine stabilize.

Myth 2: Engorgement only happens in the early days after giving birth.

Fact: Engorgement can occur at any point during the breastfeeding journey, although it commonly happens in the early postpartum period when establishing milk production. Factors such as changes in breastfeeding patterns missed feedings, or weaning can contribute to engorgement later on.

Myth 3: The only solution for engorgement is to pump milk.

Fact: While pumping milk can help relieve engorgement, it is not the only solution. The primary goal should be effective milk removal, whether through breastfeeding directly or expressing milk with a pump. A combination of breastfeeding, proper latch, hand expression, and warm compresses can also be effective in managing engorgement.

Myth 4: Engorgement means you have to stop breastfeeding.

Fact: Engorgement is a temporary phase that you can manage with proper techniques and support. Stopping breastfeeding altogether is not the solution. You can effectively manage engorgement through strategies such as frequent breastfeeding, maintaining a proper latch, performing breast massage, and applying warm compresses.

Myth 5: You should avoid breastfeeding during engorgement to let the breasts “rest.”

Fact: On the contrary, breastfeeding is crucial in managing engorgement. Frequent and effective breastfeeding helps remove milk and relieve engorgement. Breastfeeding on demand, ensuring a proper latch, and emptying the breasts regularly can help resolve engorgement more quickly.

Myth 6: Cold cabbage leaves are the best remedy for engorgement.

Fact: While some women find relief from cold cabbage leaves, there is limited scientific evidence to support their effectiveness. Instead, applying cold or warm compresses, depending on what feels more soothing, can help alleviate discomfort and reduce swelling.

Myth 7: Engorgement is a sign that breastfeeding is not working.

Fact: Engorgement is a common occurrence and does not necessarily indicate breastfeeding difficulties or failure. It is a normal part of the breastfeeding process, and you can manage it with the appropriate techniques and support. Seeking guidance from a lactation consultant or healthcare professional can help address any concerns and ensure successful breastfeeding.

Conclusion

Breastfeeding engorgement is a common challenge that many nursing mothers face during their breastfeeding journey. Manage engorgement effectively with the right strategies and support, despite the discomfort and overwhelm. By seeking help and support, breastfeeding mothers can navigate through engorgement and continue their breastfeeding journey with confidence.

It is crucial to reach out to lactation consultants, healthcare professionals, and support groups for guidance and assistance. These professionals have the knowledge and expertise to provide personalized advice, assess breastfeeding techniques, and offer practical solutions for managing engorgement. They can address any concerns, debunk myths, and provide evidence-based information to help mothers make informed decisions about their breastfeeding journey.

Breastfeeding is a beautiful and natural way to nourish your baby, and addressing engorgement is an important part of that journey. With the right help and support, you can overcome engorgement challenges and create a fulfilling breastfeeding experience for both you and your baby. Embrace support, stay informed, and have the confidence to overcome engorgement for a successful breastfeeding journey.







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