Health Education

Coping with Engorgement

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For the first day or so after your baby’s birth, your baby receives colostrum when he or she breastfeeds. Colostrum is a liquid gold breast milk concentrate. It is packed with antibodies to boost your baby’s normally immature immune system and is often called nature’s first vaccination. Colostrum is high in protein and low in volume; the small volume allows your baby to practice his or her early feedings on a soft breast. The tiny amounts are easy for your baby’s 1-2 tsp size stomach to handle.

Breast fullness occurs when the milk comes in. It is a normal part of lactation that usually happens around the 3rd day after the baby’s birth. Mothers experience fullness, warmth, and tenderness as the blood supply to their breasts increases along with their milk. Usually this normal fullness is not a big problem. The worst of the discomfort and heaviness is usually resolved in 24-48 hours. To help, it’s important to feed your baby frequently during this period. Be sure to take advantage of normal cluster feeding to keep your breasts comfortable and your nipples soft and graspable.

When does engorgement occur?

Engorgement often occurs if the baby does not nurse very frequently or the baby is not removing milk effectively when at the breast. Engorged breasts may be very firm, hard, hot and painful. The swelling may extend into your underarm. Engorgement is caused by both milk and other fluid build-up. The breast skin can become taut and shiny, and the breast swelling can flatten the nipple making it difficult for the baby to latch onto.

How can I prevent engorgement? You can avoid severe engorgement with some of these simple steps:

  • The best way to prevent engorgement is to nurse frequently!
  • Apply moist heat before feeding (warm shower, wet wash cloth, diaper with warm water in it) to help the milk let down.
  • Apply cold compresses to your breasts between feedings (ice packs, bags of frozen vegetables).
  • Soften the areola before the baby latches.
  • Massage your breasts gently.
  • Use hand expression to soften your breasts. Check out the Breastfeeding Medicine of Northeast Ohio video online for our hand expression demonstration.
  • Pump only for comfort (not to drain the breasts, but for a few minutes to relieve the pressure).
  • Ask your provider about the use of an anti-inflammatory drug such as ibuprofen.
  • Call your provider immediately if you develop a fever over 101, flu-like symptoms or redness and pain in the breast .
  • See a lactation consultant if the symptoms are not resolved in 2 days.