Breastfeeding is a big decision. It provides optimal nutrition for your baby and reinforces the mother-child bond that starts forming during pregnancy. Still, it isn’t for everyone, and in some cases it just isn’t possible. Despite how many mothers are led to believe things like tongue ties and high palettes, or low supply are indicators of breastfeeding ability, they are not. Only around 2 percent of all mothers truly cannot breastfeed, Parenting Magazine reports. Regardless of what path you plan to take in the world of infant nutrition, no new mother can avoid engorgement. Engorgement occurs when the breasts fill with milk.
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What Causes Engorgement?
When a woman gives birth, it sends a chemical called oxytocin throughout her body that signals the hormone prolactin to start producing. This hormone is responsible for milk production. At the same time, high levels of prolactin keep the hormones estrogen and progesterone low, which consequently also allows a milk supply to flourish. Higher levels of progesterone and estrogen impede milk production, which is why supply may temporarily diminish around ovulation and menses if a woman’s period returns while she’s breastfeeding. This is the same reason these hormones plummet after birth to allow for the milk supply to develop, per Kelly Mom.
As the supply begins to develop and turn colostrum into real milk between three and five days after birth, engorgement is common. To what extent a woman experiences discomfort or pain seems to vary from one new mom to the next. It’s best to avoid underwire bras while breastfeeding since they can contribute to worsening of engorgement.
Fortunately, there are a few ways to alleviate the discomfort women experience during this time. The breasts will swell as they fill with milk, and may become warm to the touch and tender. Sometimes redness may even appear. Close attention should be paid to this to rule out blocked ducts or mastitis, both of which require further intervention. A full, heavy sensation and shiny appearance to the breasts are also normal when engorged. If you’re planning to breastfeed, keeping baby on the breast as often as possible is a win-win tactic that will encourage a developing supply and also relieve engorgement.
Using a Pump
Should there be any reason that the baby can’t nurse initially, pumping can be used as a last resort. Typically, pumping isn’t encouraged before six weeks postpartum because it can overstimulate the breasts and lead to oversupply. Pumping can be used to relieve pain, but should only be used in spurts when doing such. No more than a few minutes should suffice; this alleviates the pressure that engorgement causes without signalling the body to produce more milk.
If you’re not planning to breastfeed, you can still use a pump to help with the discomfort that engorged breasts cause until your supply tapers off. For the first couple days, you’ll want to pump for 10-15 minutes, 8-12 times a day. Once your milk comes in, you’ll need to kick your pumping sessions up to around a half hour each to get a good supply established.
Nursing Your Little One
New babies nurse — a lot! Cluster feeding is normal at this stage. Mom should be nursing 8 to 12 times in every 24-hour period. While nursing, it’s a good idea to massage the breasts and apply gentle compression in downward strokes moving toward the nipple to help the breast to drain completely.
The best pain reliever to use while breastfeeding when trying to reduce engorgement is ibuprofen. This drug works by reducing inflammation. It is safe for use while nursing. The American Journal of Obstetrics and Gynaecology noted “in lactating women who take up to 400 mg of ibuprofen every 6 hours, less than 1 mg of ibuprofen per day is excreted in breast milk.” Nonetheless, it’s wise to consult with your health care provider before taking any medication while breastfeeding.
Alternatives to Medicine
The most popular method for treating engorgement and one that comes highly recommended is ice. Applying cold compresses or ice for 15 to 20 minutes after feeding or pumping reduces swelling in the breast tissue and inflammation of milk ducts. Use a barrier when applying ice to prevent injury to the skin. A bag of frozen peas is a great substitute that molds well to the shape of the breast. Contrary to popular belief, heat is not the best choice in this scenario. While it can reduce inflammation in some cases, it actually does the opposite and increases it in breastfeeding mothers, per Kelly Mom. The use of warm compresses is best reserved for times when milk isn’t flowing well, such as a suspected clogged duct.
Placing cabbage leaves on the breasts for a minimum of 20 minutes has long been touted for their effectiveness in alleviating discomfort from engorged breasts. That being said, there is some evidence that they also reduce milk supply. So, caution should be used when using them if you’re intending to keep nursing or pumping.
After a day or two, most signs of being engorged should fade away on their own. If you’re nursing or pumping frequently and still experiencing engorgement, you should monitor your output to make sure you aren’t pumping too much and causing yourself to produce more milk than necessary to meet baby’s needs. Otherwise, make sure baby’s latch is deep; hand expressing and massage can alleviate pressure in the breasts when they’re too firm for baby to latch well. You’ll also want to be sure the baby is transferring milk well. A weighted feed can confirm this. Common causes of poor milk transfer include:
- High palette
- Tongue tie
- Lip tie
- Inverted or flat nipples
- Poor latch
Engorgement is a normal process for all new moms when their milk comes in. It only becomes a problem if you are experiencing it at other times when you aren’t trying to establish supply or wean. Nonetheless, it can be easily managed by following the tips above and keeping an eye out for signs of more serious issues, like blocked ducts and mastitis.