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What is breast engorgement?
Breast engorgement is the swelling of the breasts amongst mothers who have only just recently given birth. It occurs as your body transitions from the first stage of lactation, initiated during pregnancy, to the second stage which starts just a few days after delivery, and it is when your milk production begins.
This process involves an increased flow of blood and lymph to the breasts, leading to a higher fluid volume between breast tissues that causes pain and other symptoms. Typically, both breasts are affected as a whole, causing swelling, discomfort, and pain.
Early postpartum engorgement is temporary. It usually peaks with the most intense symptoms happening around five days after delivery. By the two-week postpartum mark, engorgement typically begins to ease.
What are the causes of breast engorgement?
Several causes lead to breast engorgement and are worth taking note of if you are a lactating mother.
Baby not latching well.
If your baby does not latch onto your breast well, you may likely experience breast engorgement. Several factors can impact a baby’s ability to suck and effectively feed, which includes health conditions, and “mechanical” issues such as being tongue-tied, having a cleft lip or palate. If your baby does not have health conditions or “mechanical” issues, breastfeeding is a skill that you and your baby have to slowly develop to get the hang of over time.
Baby is not breastfed frequently.
Breast engorgement can occur in the initial days when both you and your baby are still adapting to breastfeeding. It usually takes a few days for your milk supply to align with your baby’s needs. Breast engorgement may occur when your baby gets older and breastfeeds less frequently, perhaps when they are introduced to solid foods.
Non-consistent breastfeeding schedule.
An inconsistent breastfeeding schedule may contribute to breast engorgement, as engorgement typically happens because a baby is not feeding regularly enough, which is at least eight times every 24 hours.
What are the complications due to breast engorgement?
There are some complications associated with breast engorgement if it is left untreated.
- If a blocked duct is not alleviated, it can lead to inflammation in the breast, known as mastitis. This condition makes the breast feel painful and swollen, accompanied by flu-like symptoms that can make you feel unwell. Neglecting the initial signs of mastitis may require antibiotic treatment as it can turn into an infection. If mastitis is left untreated, or if it does not respond to treatment, it can progress to a breast abscess, potentially needing an operation to drain it.
- Thrush infections can occasionally occur when your nipples become cracked or damaged. This leads to the candida fungus potentially getting into your nipple or breast. If you think you or your baby has a thrush infection, see your doctor right away.
How to relieve breast engorgement?
Here are some ways to relieve breast engorgement and make yourself feel more comfortable.
- Take a hot shower or apply hot compression to the breast just before breastfeeding or expressing to soothe them and help milk flow. Limit this action to just a few minutes, as excessive heat may worsen swelling.
- Apply a cold compress or ice pack to your breasts can help relieve pain and swelling.
- As your breasts become accustomed to filling and emptying as you feed your baby, the engorgement of your breasts should improve. Regularly feeding your baby can help prevent serious engorgement and alleviate discomfort.
- Breastfeed your baby often by increasing your breastfeeding sessions – about eight to 12 times a day. Observe your baby’s feeding cues instead of strictly following a schedule. Avoid putting your newborn on a fixed feeding schedule and refrain till they are crying from hunger to feed them. By doing so, you ensure that your baby receives the nutrients they deserve, and it also helps ease breast engorgement as well.
- While your baby is nursing, tenderly massaging the breast can encourage milk flow, and helps relieve some of the tightness and discomfort. Additionally, you can try reverse pressure softening by gently pressing on the area an inch or two from the areola, which is the dark part of the nipple. Pressing backward and upward into the breast moves the swelling away from the areola, making it easier for your baby to latch on.
- Change breastfeeding positions by breastfeeding your baby in the side-lying position. This position can aid your baby in latching on more comfortably when your breasts are engorged.
- Alternate which breast you nurse your baby on first at each feeding, allowing your baby to finish nursing on one breast before switching to the other. This process will usually take between 10 and 20 minutes.
How to reduce the occurrence of breast engorgement?
Your doctor will have a chat with you about the effective ways to reduce the occurrence of engorged breasts.
1. Avoid over pumping
Over pumping to ease engorgement can worsen your symptoms. It is a misconception that you need to constantly feed your baby or empty your breasts to treat engorgement. Emptying all the milk can lead your body to produce more, perpetuating the swelling rather than easing it.
Your doctor may recommend you use a manual pump (not electric) to extract just a small amount of milk. Alternatively, you may use a hand expression. Extracting a small amount of milk may provide you with some relief, but it is important to adhere to your doctor’s advice. Avoid pumping excessively or completely emptying your breasts.
2. Apply chilled cabbage leaves
The cabbage leaves remedy is done by placing chilled cabbage leaves on your engorged breasts. Although studies have shown this remedy has helped women relieve pain in their breasts, reduce the hardness of the engorged breasts, and increase the duration of breastfeeding, some studies also reported that the cabbage leaves treatment is ineffective.
3. Medications
Medications such as ibuprofen and acetaminophen may be prescribed to reduce pain and inflammation. You should follow your doctor’s guidance on the use of medication.
4. Manual lymphatic drainage
Manual lymphatic drainage is a gentle massage technique performed by a healthcare provider to improve lymph flow in your breasts. This can help reduce swelling. This gentle technique involves small circles in the armpits and above the clavicles, followed by gentle sweeping motions from the nipple into the armpit and clavicle area, where lymph nodes aid in draining fluid. Your doctor might also teach you to perform this technique at home.
5. Reverse pressure softening
Reverse pressure softening is a technique that applies gentle and consistent pressure around your areola. This helps move fluid away from the nipple, making it easier for your baby to latch on. Your healthcare provider will guide you on performing this technique, and you can continue it on your own. Ideally, use this technique for one to three minutes before each breastfeeding session or as long as your provider advises.
6. Wear a supportive bra
Wearing a supportive bra is crucial during this time, as it provides steady pressure to help maintain fluid movement in your breasts. Your doctor may also recommend specific bra types that may help.
Read more: Correct Breastfeeding Techniques
Make an appointment at Pantai Hospitals
While breast engorgement may be common among mothers, it should not be taken lightly, as this condition can be harmful if left untreated. Always consult your doctor if you notice changes in your breasts, and do not hesitate to openly discuss your condition with them. Your doctor will suggest the most appropriate treatment to alleviate your condition.
If you are facing challenges and need help with breastfeeding, do make an appointment with the team of Consultant Paediatricians and Lactation Consultants at the nearest Pantai Hospital to you today.
Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.
