Most new mothers, in the course of their breastfeeding journey, experience hardening and swelling of one or both breasts, accompanied by pain. This is termed as “engorgement”.
CAUSE
Engorgement happens when milk is not completely removed from the breasts. But please remember that during engorgement the breast tissue does not only get overfilled with milk; it also gets clogged up with blood and other fluids. That’s why you will not always be able to express a large quantity of milk when you relieve this engorgement by just removing the stagnant breast milk.
This engorgement can happen anytime during your breastfeeding journey. But it is more likely to happen in two scenarios:
- In the early days, when your milk transitions from colostrum to mature milk. This is termed as physiological engorgement (as it is a natural occurrence).
- When you start skipping nursing or pumping sessions. This is termed as pathological engorgement (as it would not have happened if you had followed your breastfeeding schedule stringently) and can be more troublesome.
SIGNS AND SYMPTOMS OF ENGORGEMENT
The breast will typically feel hard (sometimes rock hard) with tightly stretched skin and there will be severe throbbing pain sometimes extending up to the armpit. The nipple also gets stretched and flattened making it difficult for the baby to latch. Some of you may also experience low grade fever with chills and body ache.
HOW TO MANAGE ENGORGEMENT
While it is tempting to quickly rush towards a breast pump, please do not do so before following the steps mentioned or else you could aggravate the situation.
1) Gently massage the breast from the chest wall towards the nipple area for a few minutes.
2) Apply cold compresses for the next few minutes (cold cabbage leaves can also be used).
3) Again massage the breast for a few minutes.
4) Apply hot packs all over the breast for few minutes.
5) Now try to empty the breast by either directly nursing the baby or by using a breast pump.
If you are using a breast pump, limit it’s usage to only 15 minutes on each breast, even if there is not much milk being expressed. If you overshoot the pumping time, it may actually increase the engorgement. You may need to repeat the entire process every one or two hours, till your breast becomes soft and the engorgement is relieved.
REMEMBER
It may take a few hours to a day for the engorgement to settle. Do not panic if it does not settle down in a couple of pumping sessions. Talk to your doctor about using some pain relieving medicines.
If the painful engorgement does not settle down even after you try the above process for a day then, please consult a lactation consultant or your doctor.
By
Dr. Preeti Gangan
MBBS, DCH, IBCLC
Paediatrician and Lactation Consultant
