What is engorgement and what causes it?
It’s normal to experience engorgement, or heaviness and fullness in the breast, in the first few days after birth. When the milk “comes in”, the increased milk volume that your body is producing may cause some discomfort. Other times that this can occur are if your baby sleeps longer than normal, if you are away from your baby and unable to pump as often as you need, or if baby is going through a nursing strike. If left untreated, engorgement can lead to plugged milk ducts or mastitis, a breast infection, so it’s important to resolve engorgement soon. Feeding on cue, rather than scheduling feedings, will reduce your risk of engorgement and the problems that it can lead to.
What can I do to treat engorgement?
If you find yourself experiencing engorgement, try some cool compresses to reduce swelling. Some women also find ibuprofen helpful to reduce inflammation. Try to feed your baby right away or pump if you are away from your baby. Hand expressing some milk might also help to reduce the volume and soften the area enough so that you are comfortable, or reduce the pressure enough so that baby can latch on. Hand expression can be done by placing your thumb and fingers in a “C” shape about an inch or so behind the areola. Rolling your fingers towards the areola, while simultaneously pushing towards your chest tends to cause milk to spray. Every woman is different, so the exact location where the “spray” happens might be closer or further from the areola.
Similarly, reverse pressure softening is another technique used to reduce the swelling of the areola so that the baby can latch on. Imagine trying to grasp onto a half-way full balloon and then imagine grasping an over-full balloon. Letting some of the steam off, so to speak, makes it easier to grasp. Basically, if you take your index and middle finger on both hands and press backwards towards your chest for about 5 seconds, this is generally enough time to move the fluid out of the areola. Rotate your fingers around the areola, until all areas are soft enough. If your baby is experiencing difficulty latching, make sure that you seek the help of a lactation consultant right away. Restricting or delaying feedings can cause engorgement to be worse. Also, finding a supportive but not restrictive bra can help reduce further problems with engorgement.
What about those cabbage leaves?
While cabbage leaves have a reputation for reducing engorgement (maybe because they are breast-shaped and cool if refrigerated) they haven’t been found to be any more effective than any other cool compress. In addition, unwashed cabbage leaves can cause food borne-type illness in babies.
When to talk to a professional
If you’ve tried these suggestions and you’re still feeling uncomfortable, or if your engorgement is interfering with your ability to breastfeed, then you should talk to an IBCLC (International Board Certified Lactation Consultant). IBCLCs has years of experience working with breastfeeding moms, and can offer your advice that is just for your situation.