Engorgement Management

Your breasts will start to increase milk production 2-5 days before giving birth. As your milk supply begins, it is normal for you to feel mild heaviness, warmth and swelling in your breasts. After your baby is born, if breastfeeding or pumping doesn’t empty your breasts, your breasts can become engorged. Engorgement is when your breasts are tender, swollen, firm, warm, and/or lumpy to touch.

Experiencing Symptoms of Engorgement

You can:

• Soften your breasts with a warm and gentle massage, prior to pumping or breastfeeding.
• Continue to remove the milk by routinely feeding or pumping a minimum of 8 times a day.
• Wear a well-fitting supportive bra that does not have wires.
• Take Ibuprofen, unless you have been told not to by your doctor or medical provider. Read and follow the directions on the label.
• Apply cold compresses (ice packs over a layer of cloth) between feedings; 20 minutes on, 20 minutes off; repeat as needed. Stop using the ice when you are able to remove the milk from your breasts and your breasts soften after feeding or pumping. Apply warmth for a few minutes before latching and this will warm breasts after icing to assist with letdown.
• Use therapeutic breast massage techniques. We encourage mothers to use alternating hand expression and gentle breast massage to help decrease swelling and make it easier to remove the milk while you are breastfeeding or pumping.

Reference videos: bfmedneo.com and firstdroplets.com

Preventing Engorgement

• Nurse your baby early and often
• Do not skip feedings, especially at night, when hormones for milk production are higher
• Do not offer formula or pacifiers to your newborn, unless medically indicated
• Nurse your baby on demand, don’t limit time at the breast
• Watch the baby, not the clock
• You can nurse on one side then switch to the other when ready to nurse again

Mastitis

Severe engorgement can lead to blocked milk ducts and breast infection, called mastitis. Mastitis may need to be treated with antibiotics. Warning signs that you may need to have a health professional assess your breasts are:

• Fever
• Flu-like symptoms
• Red firm lumps or red streaks in breasts
• Continued pain after the above suggestions