ENGORGEMENT

ENGORGEMENT

Is This Supposed to Happen?

Every new mother will notice some degree of fullness in her breasts as her milk supply increases after delivery.  Your breasts will feel heavier and warmer, and sometimes uncomfortable.  It usually occurs between day 2 and 6 after your baby is born, and won’t last more than 24 hours.  If your breasts and areola remain soft and elastic, and your milk is flowing well and the baby is able to latch without a problem, there is no need for concern.  Some mothers have several peaks of this fullness, which then resolves. 

What Can I Do to Prevent or Minimize Engorgement?

• Breastfeed your baby as soon as possible after birth. 
• Alternate the breast that you offer first for a feeding. 
• Breastfeed the baby every 1 to 3 hours--at least 10 times or more in 24 hours. 
• Do NOT skip feedings. 
• Watch for the baby’s feeding cues to determine when to feed ( mouthing, bent arms, clenched fists, fists near face    or mouth) Feed as soon as you see any of these feeding cues.  Crying is a late feeding cue.  The baby will feed better if you feed him before he starts crying. 
• If baby is very sleepy, during the day, wake to feed every 2 to 3 hours.  At night, or sometime within a 24 hr period,   you may allow one 4 to 5 hour stretch between  feedings. 
• Make sure the baby empties the first breast before switching sides.  Don’t limit time at breast.
• With good positioning and latch, the baby should feed well and the breasts should be soft after a feeding.  If that is not the case, be sure to get help from a qualified professional lactation consultant.      
• Avoid using a pacifier during the first month of breastfeeding.

When Does Engorgement Typically Occur?

• Engorgement usually begins on the 3rd to 5th day after the baby is born. 
• If you had a cesarian section, it could occur 24 to 48 hours later. 
• With proper treatment, it should subside  within 12-24 hours.  Without good management, it can last up to 7 to 10 days     
• Prolonged engorgement causes milk stasis and predisposes a mother to mastitis as well as decreasing milk   production. 

What Are the Symptoms of Engorgement?

• Every mother experiences engorgement differently, but there are typical symptoms.
• The breast will feel hard with taught skin.  The skin may appear shiny with distended veins.  The skin may feel extra warm, throbbing, and be somewhat tender.
• These symptoms can occur in one or both breasts, part of the breast, or all of the breast.
• Some mothers have engorgement that extends up into their armpit.
• Engorgement in the areola can make the nipple more flat and make it difficult for the baby to latch-on well.
• Some mothers experience a low-grade fever.
• Some mothers experience a peak of engorgement which then decreases.  Others have several peaks.  Some have quick resolution, others resolve more slowly. 

More to follow about how to treat engorgement....


Full text with endnotes available upon request.

This is copyrighted November 2010 Kathleen L. Gale RN, IBCLC, RLC