Breastfeeding Concerns: Engorgement

What is Engorgement?

Engorgement is, quite simply, swelling of the breasts, which can be uncomfortable and/or painful. It is caused by the breasts being very full with milk. This fullness is common when milk first comes in, a few days after birth, but can reoccur if breasts are producing more milk than Baby is drinking, for example in cases of oversupply, if you’ve been pumping a lot and then stop, if you stop or reduce breastfeeding, if you miss feeds (for example when your baby starts sleeping through the night) and sometimes comes and goes while your supply is still becoming established.

What are the Symptoms of Engorgement?

If your breasts are engorged, they will usually feel heavy, firm and very tender to the touch. They might also leak, so it’s a good idea to use breast pads. When breasts become very engorged it is sometimes difficult for babies to latch on and feed as engorgement can make your nipples flat. If you notice your baby is becoming frustrated at the breast and does not seem to be able to stay latched on, it could be because your breasts are engorged so you might need to reduce the engorgement (see below) to allow your baby to feed properly. This can sometimes occur first thing in the morning, if your baby has slept longer than usual. You can sometimes have a low grade fever of around 100 degrees F. It’s important to also be aware of the symptoms of mastitis, which are when the breasts can be hot, very painful, red and you might have a higher fever of over 100 degrees F as this can sometimes be confused with engorgement, but is much more serious. If you think you have mastitis you should contact your doctor.

What Do I Do if My Breast are Engorged?

Breast engorgement can usually be relieved at home quite easily. The best thing to do is feed your baby, which usually helps the discomfort subside. If your breasts still feel sore, you could try a cold compress or some paracetamol. Using gentle breast compressions while your baby feeds can also help. If the engorgement is so severe that your baby can’t latch on, just hand express a little milk into a nappy or muslin cloth to reduce it until your baby is able to feed. Some people also find a warm shower can help. If your engorgement is due to a natural change in your baby’s demand pattern, for example your baby is sleeping for longer at night, it’s best not to pump too much or your body will keep producing that amount of milk and you’ll always need to relieve the engorgement. Just pump or hand express enough to relieve the engorgement and your body should adjust within a few days. If breasts are not emptied efficiently, this can lead to clogged ducts or even mastitis so it’s really important to be aware of these symptoms and ensure your breasts are emptied.

How can I prevent Engorgement?

There are lots of ways you can prevent engorgement and these will help make breastfeeding go much more smoothly for both you and your baby. The best thing to do is to nurse your baby frequently, so that your milk ducts are emptied. If your baby is not feeding as often as usual, for example during a nursing strike, then you can express milk and store it, both to keep your supply up and prevent engorgement occurring. If you find that your breasts are becoming engorged often, it’s a good idea to attend a breastfeeding support group and ensure your baby is correctly latched onto your breasts during feeding.

If you have any concerns always contact a healthcare professional.

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