How to prevent and relieve engorged breasts

Breast engorgement is a common challenge for breastfeeding moms, and it’s one of the reasons why some moms quit breastfeeding during the first month. Here’s how you can relieve or prevent breast engorgement. By Xanet van Vuuren

Breast engorgement is the painful overfilling of the breasts with milk. “It’s usually caused because there’s either too much milk in the breasts, or too many other fluids (blood and lymph retention). Engorgement is painful, and it’s one of the reasons why a quarter of moms stop breastfeeding in the first month,” says Pretoria-based La Leche League Leader, Leani Khan.

Signs of engorged breasts

Severe engorgement usually starts around the third or fourth day after birth, but it can also occur whenever milk hasn’t been expressed from the breasts for longer periods than usual. The most common signs of engorgement are:

  • breasts that feel hard, with tight, shiny skin
  • swelling that can extend up into your armpit, which is usually uncomfortable and tender
  • nipples that stretch, making it difficult for baby to latch.
  • breasts that feel warm or that throb, which can be accompanied by a low fever.

Can engorgement be prevented?

If babies nurse well from the beginning, engorgement can be completely avoided or at least minimised. Khan advises that moms should start breastfeeding as soon as possible after giving birth. Nurse your newborn at least 10 times a day for as long as he wants. “Keeping your baby in your arms makes this much easier to achieve. Wait until your baby releases from one breast or falls asleep on the breast before you switch sides,” she adds.

Make sure that your baby is latched on well and that you’re in a comfortable position when you feed him. Breastfeeding shouldn’t be painful.

If your baby is not nursing well, express your milk as frequently as you would breastfeed, in order to prevent engorgement.

Handy tips

Even without treatment, engorgement doesn’t last more than a few days. These tips from Pretoria-based La Leche League Leader, Leani Khan, will help relieve the discomfort and help your baby nurse more effectively:

  • Drain your breasts frequently. Remember that a newborn should nurse at least 10 times a day.
  • If your baby isn’t nursing, express your milk frequently.
  • If latching is proving difficult, work on improving it. Reverse pressure softening can also help. Click here to read more about this technique.
  • Apply a cold compress, like a bag of frozen peas wrapped in a towel, or cool cabbage leaves to help the swelling go down. Lightly crushed cabbage leaves (at room temperature) can also be used.
  • Your healthcare provider might recommend anti-inflammatory medication.
  • In cases of severe engorgement, it can help to thoroughly, but gently, drain your breasts by hand, by expressing or pumping. This will allow the other fluids that are causing the oedema (lymph retention) to drain away. Once your breasts are soft, breastfeeding on cue should prevent further engorgement.

What to do if baby has trouble latching

“Skin-on-skin contact is an amazing way to help your baby latch. It activates his reflexes and instinctive behaviour,” explains Khan.

Lean back and place your baby (naked except for a nappy) on your bare chest, and just relax. Let your little one sleep, explore, smell, touch and taste. Spend as much time as possible like this.

If you prefer nursing sitting up or lying down, make sure your baby’s tummy is right up against your body.

“Don’t wait until your baby is crying to breastfeed. Early cues of hunger include fluttery eye movements, closed fists, fidgeting, squeaking or moaning, sucking, rooting (searching reflex) on the chest of the person who’s holding him, and turning on his side when touched on the cheek,” says Khan.

“If engorgement is making it difficult for your baby to latch, gently press your fingertips around the base of your nipple to soften the area,” adds Khan.


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