Breast engorgment

Relieving engorged breasts

If you are experiencing hot, shiny, painful breasts, this is known as breast engorgement. Engorgement is general congestion of blood, milk, and lymph, and this situation must get rectified as quickly as you can.

You may be wondering why this engorgement has happened. There are numerous reasons that this can occur. 

It may be a missed feed – your baby went just a little bit longer than usual while feeding at night or in the daytime.

It may be a missed pumping session, or you may have been trying to wean your baby from the breast (stop breastfeeding) too quickly.

It may be that you are feeding your baby to a schedule.

Any of these could potentially cause engorgement, and it can happen suddenly too.

Coupled with the distress of the engorgement itself, you may find that your baby is now struggling to latch at the breast.

Due to your breast becoming engorged, which means the nipple and the areola area also become engorged, and your nipple may feel flatter to your baby.

This, in turn, may cause an added challenge for your baby while trying to latch.

It’s important for your baby to latch, and to find a way to get your nipple protruding again. One useful strategy is to use hand expression before trying to latch.

Hand expression will enable you to get a small amount of milk expressed from the breast, enabling your nipple to protrude better. This will provide the needed stimulus for your baby to latch again.

If you find that hand expression itself has not caused your nipple to protrude enough to enable your baby to attach, another technique called reverse pressure softening can also be very useful. It may sound crazy, but the method does work.

It involves lying flat on your back and using a V shape with your fingers pressed into the breast with the nipple protruding through, 60 seconds before latching. 

As you are lying on your back, you will be pressing in as if you’re pressing into the floor, which will push fluid back inside the breast, enabling your nipple to protrude better.

You can do this 30 to 60 seconds before trying to latch – which is often enough to allow your baby to latch better.

I would encourage you to look at the information relating to reverse pressure softening and hand expression techniques and practice these.

Secondly, you must have the best latch at the breast so that your baby can drain the breast as well as possible.

Offer both breasts at each feed. Let your baby feed for as long and as often as he wants.

When you feel that he has had a good feed at the breast with lots of swallowing, then offer the other side. 

Look out for feeding cues. Bring your baby to the breast as frequently as needed, night and day, to keep your breasts as soft as possible.

Thirdly, use a combination of warmth and cold. First of all, between feeds, use a cold compress, such as a bag of frozen peas wrapped in a thin, clean towel, and place on your breast for 15 minutes.

You will find this will help to relieve any congestion. Then you need warmth on the breast – even just five minutes before latching your baby. A bath, a shower, a warm compress on the breast, and massage – all of this will help to get your milk flowing.

So to deal with breast engorgement, this combination of warmth and cold is quite a powerful tool. 

It may also be necessary for you to take an anti-inflammatory medication like Ibuprofen 400mg dose, to reduce inflammation while you’re experiencing engorgement.

Be assured that engorgement is a temporary situation, and breastfeeding can continue.

Review dates, references & further resources

Review Dates

Version 1.1 published in March 2019. Next review date: Jan 2022

References

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