Pictures of breastfeeding always make me feel a little verklempt. It’s usually a mother and child captured in perfect glowy lighting. I can practically smell the oxytocin wafting off the page. You know what I don’t see pictures of, though? Breast engorgement.
The uninitiated among us are wondering what exactly I’m referring to. But there’s at least one breastfeeding woman who winced a little at the word.
Engorgement is defined as “the condition of being full beyond satisfaction”, and I’ve never seen a more apt description. No one is satisfied with swollen, milk filled breasts.
You’ll know that your breasts are engorged when they’re heavy and full. They’ll likely be tender to the touch and may throb some or feel warm. Because of the fullness, your skin might appear stretched and shiny, which could flatten your nipples some as a result.
Why does breast engorgement happen?
Thankfully, it’s somewhat predictable. We expect to see it in new mothers sometime in their first week after birth as their milk supply transitions from colostrum to mature milk. When milk “comes in” (for the record, colostrum is milk for your baby), the volume in your breasts increases and can easily lead to engorgement.
Engorgement is also a response to breasts that haven’t been emptied in a while, either by baby, hand expression, or a pump. Many mothers notice this if their baby sleeps longer than usual, or as they return to work and haven’t gotten into a good pumping schedule.
What can you do?
The initial engorgement is often resolved within 24 hours, and is primarily solved by continuing to feed the baby. The importance of emptying your breasts continues through your breastfeeding journey. Not only to prevent painful symptoms, but also to signal to your body that your baby is still eating. Engorged breasts suggest that your body is making too much, and in time your body will slow down production.
So to manage this initial fullness, you’ll want to feed your newborn on demand. If your baby tends to be sleepy (like many are), you’ll want to wake them every 2-3 hours during the day and after 4 hours at night.
Besides removing milk, try the following tips to relieve breast engorgement:
- Warm compresses to stimulate let down before a feed. A warm washcloth for 5-10 minutes often encourages milk to flow. You might also find it helpful to try a warm shower before nursing or pumping.
- Cold compresses between feedings. This can reduce swelling (keep in mind that the warm compresses might encourage inflammation) and relieve some discomfort. You’ll want to apply these in a 20 minutes on, 20 minutes off cycle.
- Cold cabbage leaf compresses can also help with engorgement. You’ll want to remove the inner stems of the leaves, and flatten them. Then place the leaves directly onto the breast, inside your bra. (If you plan to continue breastfeeding, you’ll want to remove the leaves when the engorgement subsides so that you don’t risk lowering your milk supply).
- Massaging the breasts can encourage the release of milk. Applying pressure in a circular motion from the collarbone down to your nipple is particularly effective, and when done in the shower some women experience sprays of milk and a sigh of relief.
- If your nipples have become flattened, or you’d describe your breasts as “hard as rocks”, your baby will have trouble latching. Reverse pressure softening is a technique that can help. (Click the link for a helpful video!)
Engorgement is uncomfortable and best, and often pretty painful. It can cause frustration for both babies and parents, and since it often happens early in breastfeeding, it can make things seem impossible.
But please know that many people experience it, and go on to nurse their babies as long as they like. Unfortunately in the meantime, what we can do is relieve the symptoms and wait until it passes.
In an effort to be encouraging, I once heard a lactation consultant say, “Don’t quit on a bad day.”
I think that if I read that while engorged, what I might quit was talking to whoever said that to me. So instead, if you’re reading this with cabbage leaves in your bra, or while applying reverse pressure to your areolas, I’ll say this:
Sometimes we do really hard things in an effort to be the kind of parents we want to be. It sucks. Thankfully, in the case of breast engorgement, it’s temporary. Know that your doulas will support you regardless of what you decide to do- cabbage OR quitting.
Also, please note: if you’re experiencing a fever, have had prolonged breast engorgement or have pain that’s not described here, please seek a professional. At DCMM, some of our trusted lactation referrals include:
Learn more about our postpartum support here!
