Relieving engorged breasts
If you are experiencing hot, shiny, painful breasts at the moment – this is actually called engorgement, and it’s a general congestion of blood and milk and lymph, and it is really important that this gets sorted out as quickly as you can.
You might be wondering why this engorgement has happened, but really it can happen for many different reasons. It may be a missed feed, your baby went just a little bit longer, feeding at night or in the daytime. It may be a missed pumping session, you may have been trying to wean from the breast too quickly perhaps, or feeding your baby on a schedule. Any of those things can be a reason for engorgement, and it can certainly happen out of the blue.
Coupled with the distress of the engorgement itself you may find that your baby is now struggling to latch at the breast. This happens usually because, when the breast becomes engorged, the nipple and the areola area also become engorged, and your nipple can feel flatter to your baby, so the feel will be different. This may affect your baby actually latching on.
So it’s really important that your baby is able to latch again and to somehow find a way to get your nipple protruding again, because that nipple starts to feel flattened to your baby. What you can do is to use hand expression, before you try to latch the baby, so getting that small amount of milk off the breast can be enough to cause the nipple to protrude, better than it did, and to provide that stimulus for your baby to get latching – back into the swing again.
Now if you find that the hand expression itself is not really helping adequately to enable your baby to attach, another technique called reverse pressure softening can be a very very useful thing to do to aid the protruding of the nipple again. It sounds a really crazy thing but you would literally lie flat on your back and if anyone has ever watched Star Trek ‘live long and prosper’, a V shape with your hand, pressed into the breast with the nipple protruding through, 60 seconds before latching. So as you’re lying on your back, you’re pressing as if you’re pressing into the floor actually. This in effect is pushing fluid back inside which will enable the nipple to protrude better, maybe 30 to 60 seconds before the latch. Somewhere around there is usually enough to enable your baby to latch better.
What I would suggest is that you look at the videos relating to reverse pressure softening and hand expression technique, so that you can really practice with these things, and if you find yourself in this situation you will very easily be able to rectify that.
Secondly, it’s really important that you have the best latch at the breast so that your baby is able to drain that breast as well as possible and 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 drained the breast as well as he is going to do, then offer the other side and watch his feeding cues. Bring your baby to the breast as frequently as is needed throughout the night and the day, to keep your breasts as soft as possible.
Thirdly, it’s important that you use a combination of warmth and cold. Now first of all, between feeds, a cold compress – that can be a bag of frozen peas if you want, wrapped in a thin dish towel, placed on your breast for maybe 15 minutes. That will help to relieve any congestion that’s going on. Then you need warmth, maybe five minutes just before latching your baby, so a bath, a shower, a warm compress on the breast, and massage – that will help to get the milk flowing.
So think about for engorgement: a combination of warmth and cold, and this combination is quite a powerful tool.
It may be necessary for you to take an anti-inflammatory medication like Ibuprofen 400mg dose, just to help to keep any inflammation down, while you’re experiencing this engorgement, but please be assured that engorgement is a temporary situation and breastfeeding will be able to go ahead as normal.
Review dates, references & further resources
Version 1.1 published in March 2019. Next review date: Jan 2022
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