With a new baby, comes many new sensations including the let down reflex, signaling the flow of maternal milk. When you have an abundant flow of milk, it can lead to engorgement. Engorgement is a sensation of fullness in the breasts that results from an over-production of milk. Within 72 hours after you give birth, a rush of breast milk becomes available to your baby. More blood flows to your breasts and some of the surrounding tissue swells, including the underarm region. The result is full, swollen, tender, hot, engorged breasts. Although it may be quite painful, engorgement is also a good sign—it means you’re producing milk abundantly, you just want to get it under control. The pain won’t last very long, usually up to 48 hours initially. It takes the body a few days to adjust to producing the right amount for your baby’s needs. The body doesn’t know whether you just birthed one baby or multiples, so it produces lots of milk until it gets a sense of how much is needed especially if your baby nurses on demand.
Here are 10 tips for managing engorgement.
- Switch it up. In the first few days after birth, nurse your baby on each side for a maximum of 15 minutes at a time, even if she is comfortable and perfectly latched, it’s important to switch so you can ease into the onset of the milk production. Your breasts will stay a little softer making it easier for your little one to latch on.
- Use cabbage leaves. This is a folk remedy. You peel back a layer or two of green cabbage and place it inside your nursing bra to cover your breast completely. You can leave them in for a minimum of 20 minutes, or you can leave them in until the cabbage completely wilts. The coolness and the sulfur in the cabbage—produced by the amino acid methionine—combine to act as an antibiotic and anti-irritant. This reaction in turn draws an extra flow of blood to the area, resulting in dilation of the capillaries, which is a counterirritant as well. Engorgement and inflammation are relieved, milk flows more freely, and you experience great relief.
- Take a warm shower or bath. Allow the water to gently pour directly over your breasts. The heat will cause vasodilation, causing your milk will begin to leak in the shower, and allowing the breasts to deflate enough that they feel comfortable. Since the breasts aren’t being stimulated, your body won’t consider the leaking a feeding and you won’t have to worry about producing more milk to account for the leaked milk.
- Get comfy. Wear comfortable clothing that doesn’t cling too tightly around the chest area and doesn’t cause any rubbing.
- Keep it cool. Apply a cold compress for up to 20 minutes before a feeding. This can be helpful in reducing pain.
- Feed your baby frequently. Feed every two to three hours at least,
even if it means waking baby up. This is crucial, because unrelieved engorgement can cause a drop in your milk production. Try to get the breast as soft and deflated as possible. If your baby is satisfied with just one breast, you can offer the other breast at the next feeding.
- Try breast massage. While nursing, gently massage the breast to get blood flowing. This will help decrease some of the inflammation.
- Contact a lactation consultant. Lactation consultants can show you some helpful tips. They’re usually flexible with where they see patients and can come to your home upon request. Check with your birth service provider to see if they have any partnerships with lactation consultants.
- Use herbs. A fenugreek-seed compress is a traditional remedy used in India
to relieve engorgement and mastitis (inflammation of the breasts). Steep several ounces of fenugreek seeds in a cup or so of warm water. Let the seeds cool and then mash them. Place mashed seeds on a clean wet cloth while still warm, and use as a poultice on engorged or mastitic breasts to help with milk ejection and sore spots. You can also get prepared teas and tinctures for nursing moms.
- Stick with it. Have faith, it gets easier and you are learning as you go. Your baby is learning to breastfeed just as you are learning how to get comfortable feeding your baby.