Breast engorgement

Breast engorgement occurs when the breasts become painfully full of milk. This happens when a baby drinks less milk than the mother's glands produce.

This is why mothers often stop breastfeeding prematurely.

[ 1 ], [ 2 ], [ 3 ], [ 4 ]

Causes breast engorgement

Breast engorgement occurs:

• when milk comes in in the first days after birth;
• if normal breastfeeding is disrupted and there is no way to express milk or use a breast pump;
• in case of abrupt cessation of breastfeeding;
• during the introduction of solid foods, the child consumes less breast milk, as well as in the event of a lack of appetite or illness of the child.

The mammary glands begin to produce milk on the 2nd-5th day after birth. During this period, the breasts become heavy and the temperature rises. Sometimes the glands slightly increase in volume, and in some cases they become painful.

Filling the breasts with milk immediately after birth is considered normal. The mammary glands increase milk production, and the baby has not yet established a feeding regime. Filling the mammary glands with milk occurs due to excess milk, as well as blood and fluid. The body uses excess fluid to produce more milk to feed the baby.

If you do not start breastfeeding immediately after birth, you will experience moderate engorgement of the mammary glands for several days. This will pass over time, unless milk production is stimulated. Over-engorged mammary glands easily become engorged and very painful.

Causes of breast engorgement:

• the baby is not fed immediately after birth;
• irregular feeding;
• The baby consumes a small amount of breast milk, as he is fed with dry milk formulas or given additional water.

Severe engorgement of the mammary glands means that the baby cannot latch on to the breast properly. As a result:

• the child does not drink enough milk;
• the mammary glands are not completely emptied;
• Nipples become sore and cracked as the baby tries to latch onto the overfilled breast. If you feed less frequently because of sore nipples, engorgement progresses.

If this problem is ignored, engorgement leads to blockage of milk ducts and infection - mastitis.

[ 5 ], [ 6 ], [ 7 ]

Symptoms breast engorgement

Symptoms of breast engorgement begin to appear when a lot of milk is produced and a small amount is used. The following symptoms are observed:

• Swelling, hardness and soreness of the mammary glands. With severe engorgement, the glands enlarge, become hard, hot and lumpy when touched.
• The dark area around the nipples (areola) becomes very hard.
• It is difficult for the baby to latch on to flat, hard nipples and consume sufficient amounts of milk.
• If your baby can't get enough milk, he will suckle harder and you will have to feed him more often.
• Your nipples may become injured as your baby tries to latch on and get enough milk.
• Temperature increase.
• Slight enlargement of the lymph nodes in the armpits.

Complications and consequences

If you are breastfeeding and do not feel relief (engorgement of the mammary glands does not go away), the risk of developing complications increases:

• milk duct blockages
• infection of the mammary glands - mastitis.

Seek medical attention if:

• increased pain in one area of the mammary glands;
• redness in one area of the chest or the appearance of red streaks;
• discharge of pus from the nipples or other area of the breast;
• an increase in temperature to 38.5 degrees or higher.

Contact your doctor immediately if:

• enlarged lymph nodes in the neck or armpits;
• elevated temperature.

Call your doctor at any time of day if your nipples become cracked or bleed after home treatment.

[ 8 ], [ 9 ]

Diagnostics breast engorgement

A doctor will determine breast engorgement based on symptoms after a physical examination. Diagnostics are not used to determine breast engorgement.

If your doctor suspects a breast infection (mastitis). You will be prescribed a course of antibiotics. Sometimes a special analysis of breast milk is done to detect a bacterial infection.

[ 10 ]

Treatment breast engorgement

After childbirth and during breastfeeding, breast engorgement often occurs. But you can take preventive measures and try to get rid of this problem at home. You should go to the doctor only if symptoms of infection (mastitis) appear, for which a course of antibiotics is prescribed.

If you are not planning to breastfeed, remember that there are currently no safe medical drugs to "dry up" or prevent milk production.

A few days after your mammary glands have started producing milk, your body must determine the amount needed to feed your baby. Relief usually occurs within 12-24 hours (or 1-5 days if you are not breastfeeding). Symptoms of engorgement should usually disappear within a few days. If this does not happen, or your glands do not become soft after feeding, you need to begin a course of therapy.

To relieve pain and swelling, take ibuprofen, apply a cold compress or ice, and wear a supportive nursing bra that is not too tight. To soften your breasts before feeding, apply a warm compress, massage gently, and express a little milk by hand or with a breast pump. If your baby refuses to feed because of illness, express the milk and store it in the refrigerator for later use.

If you still feel pain after feeding, apply a cold compress. If you are not breastfeeding, do not stimulate your nipples or apply warm compresses. Instead, apply cold compresses, take anti-inflammatory and pain-relieving medications, and wear a special support bra.

Home Treatment for Breast Engorgement

To prevent severe engorgement of the mammary glands:

• Start breastfeeding your baby immediately after birth and try to feed frequently. Offer your baby your breast every hour or two when you are awake. This is the best way to prevent severe engorgement.
• Feed your baby whenever he or she wants, or at least every 2 hours.
• Make sure your breasts are soft and your baby is latching on properly. If your breasts are hard and full of milk, first express some milk by hand or with a breast pump before you put your baby to your breast.
• The breast should be left empty after each feeding.
• The baby should suckle on the first breast for at least 15 minutes or longer before moving on to the other. You will know when to switch breasts as the suckling becomes less intense.
• If the baby does not consume all the milk, it is necessary to express the remainder manually or with a breast pump and store it in the refrigerator for later use. This is especially important in the early stages of breastfeeding.
• The engorgement of the mammary glands that is observed immediately after birth will pass as the feeding regime is established, when the baby will regularly latch on to the breast and suck for a longer period of time.
• Change your baby's position periodically during feeding.
• Make sure your baby is latched on correctly. If your nipples become flat, gently massage them and the areola. Hold your breast with your thumb on top and your fingers underneath to make it easier for your baby to latch on.
• If you have any questions about breastfeeding, please discuss them with a lactation specialist.

If feeding is going well, take the following steps to avoid engorgement in the future:

If your breasts are very full of milk, take a warm shower; the flow of water over your breasts will trigger the milk-expression reflex, causing your nipples and areola to become softer. Remove excess milk and relieve tension in your breasts by expressing a little with your hands or using a breast pump.

If your milk doesn't come in, place a warm, damp towel on your breast before feeding.

• Whenever feeding is not possible, express milk every 3-4 hours.
• When you and your baby are ready to stop breastfeeding, do it gradually over several weeks. First, skip the feeding time that is most inconvenient for you. Wait until your milk supply decreases. Then skip another one, and so on. This method of weaning is best for you and your baby. Your breasts can gradually adapt to the decrease in lactation, and your baby will adjust to new foods.

How to relieve symptoms of breast engorgement?

If you need to feed your baby, but this is not possible due to severe engorgement of the mammary glands, use the following recommendations:

• To avoid damage to the nipples, you need to soften them, as well as the areola area. After this procedure, it will be easier for the baby to latch on to the breast.
• If milk leaks out, apply a warm compress for a few minutes before feeding.
• Carefully express the milk manually or with a breast pump. Try not to damage the muscle tissue of the mammary glands. It is best to use an automatic breast pump.
• A light massage helps milk flow.
• Feed your baby more often or express milk if your baby refuses to feed. This will relieve engorgement. Expressed milk can be frozen in special containers and used during the next feeding.

After feeding, swelling and pain should be relieved.

• Take a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Advil or Motrin), in addition to non-drug treatments. If you follow the directions carefully, ibuprofen is safe to take while breastfeeding.
• Apply cold compresses, ice, or frozen vegetables to your chest for 15 minutes as needed. To avoid muscle damage, do not apply ice directly to your skin. Place a thin cloth over the area where you will apply the ice first.
• Try applying cabbage leaves. Place them directly into your bra. Change the leaves every two hours. Some nursing mothers find this helpful, but there is a slight decrease in milk flow.
• Avoid wearing constricting bras as they also reduce milk production by blocking the ducts.

If you are formula feeding your baby and experience pain in your mammary glands, use the following recommendations:

• There is no need to express milk. This will simply further stimulate milk production and worsen engorgement. Express as much milk as is needed to relieve the pain.
• Take ibuprofen (Motrin or Advil) along with non-drug therapy.
• Apply compresses, ice or frozen vegetables to your chest for 15 minutes as needed. To avoid muscle damage, do not apply ice directly to the skin. Place a thin cloth over the area where the ice will be applied first.
• Try applying cabbage leaves. Place them directly into your bra. Change the leaves every two hours. Some nursing mothers find this helpful, but there is a slight decrease in milk flow.
• Wear a supportive, comfortable bra.

Relieving symptoms of breast engorgement

The goal of breastfeeding self-help is to increase milk flow (the breast should be empty after each feeding). Make sure your baby is latching on properly and is getting enough milk. Relief usually occurs within 12-24 hours, and discomfort goes away after a few days.

If you are not breastfeeding, engorgement will subside when milk production stops. Pain and discomfort will subside within 1-5 days. Home treatment may be needed to relieve symptoms.

Prevention

Preventing breast engorgement involves expressing milk and preventing leakage. During the first two weeks after birth, when your body is adjusting to breastfeeding, make sure your breasts do not become over-filled.

• Feed your baby as he or she desires. If the glands are hard, express a little milk to soften the glands and make them more comfortable for the baby.
• Make sure your baby latches on properly and eats well.
• The baby should empty the mammary glands every time during feeding. This helps to produce the necessary amount of milk.

If you have any questions, please consult a breastfeeding specialist.

[ 11 ]