Engorgement

    After birth, your baby receives colostrum when he or she breastfeeds. Colostrum is a ”liquid gold” breast milk concentrate. It is packed with antibodies to boost your baby’s normally immature immune system and is often called nature’s first vaccination. Colostrum is high in protein and low in volume; the small volume allows your baby to practice his or her early feedings on a soft breast. The tiny amounts are easy for your baby’s 1-2 tsp size stomach to handle.

    Breast fullness occurs when the milk comes in. It is a normal part of lactation that usually happens 3 to 5 days after birth. Mothers experience fullness, warmth, and tenderness as the blood supply to their breasts increases along with their milk. Usually this normal fullness is not a big problem. The worst of the discomfort and heaviness is usually resolved in 24-48 hours. To help, it’s important to feed your baby frequently during this period. Be sure to take advantage of normal cluster feeding to keep your breasts comfortable and your nipples soft and graspable.

  1. When Does Engorgement Occur?
    Engorgement typically peaks at postpartum day 5. On average it lasts about 4 days. It can be more severe if the baby does not nurse very frequently or is having trouble removing milk. Engorged breasts may be very firm, hard, hot and painful. The swelling may extend into your underarm. Engorgement is caused by milk and fluid build-up. The breast skin can become taut and shiny, and the breast swelling can flatten the nipple making it difficult for the baby to latch.
  2. How Can I Lessen Engorgement?
    You can avoid severe engorgement with some of these simple steps:

    • The best way to prevent engorgement is to nurse frequently!
    • If latching difficulty, soften the areola with hand expression and massage before the baby latches
    • Prior to latching: massage the breast toward the arm pit (this decreases swelling) and soften the areola with reverse pressure softening and/or hand expression
    • Click here to view the Breastfeeding Medicine of Northeast Ohio video online for our hand expression and massage demonstration
    • Express milk only for comfort (not to drain the breasts, but for a few minutes to relieve the pressure)
    • Apply cold compresses to your breasts between feedings (ice packs, bags of frozen vegetables)
    • Ask your provider about the use of an anti-inflammatory drug such as ibuprofen
    • Call your provider immediately if you develop a fever over 101, flu-like symptoms or redness and pain in the breast
  3. When to See a Lactation Consultant
    See a lactation consultant if the symptoms are not improving in 2 days or if your baby won’t latch, you are unable to express milk, or if you are considering quitting due to the discomfort.