How to Reduce Postpartum Breast Engorgement

Shortly after the birth of each of my children, I have experienced severe breast pain due to breast engorgement. Lactation consultant and author of Breastfeeding: A Guide for the Medical Profession, Dr. Ruth Lawrence, states that engorgement of the breast involves two elements:

1. Increased blood flow throughout your body due to the removal of the placenta

2. Edema (fluid retention and swelling)

The combination of increased blood flow and edema results in breasts that are congested with milk. This congestion leads to breast swelling, allowing fluid in the blood vessels to seep into breast tissue which can cause a lot of discomfort for mom. 

When your milk comes in, your breasts will feel heavy, full, and warm – but this feeling should only last about 24 hours. A mother who is experiencing breast engorgement typically has discomfort and sometimes a low grade fever. Breasts that are engorged are hard and uncomfortable with tight, translucent skin. The pain and distention often can extend into the underarm area. More severe breast engorgement can also cause numbness and tingling in the hands from pressure on an individual's nerves.

Image via Flickr/Raphael Goetter
Image via Flickr/Raphael Goetter

Treatment of Breast Engorgement:

Breast Massage

Before nursing, it is helpful to gently breast massage from the chest wall toward the nipple area.

Reverse Pressure Softening

Engorgement can also result in flattened-out nipples, making it difficult for your baby to achieve a proper latch. Reverse Pressure Softening is a technique to remove the fluid and make it easier for your baby to latch.

{ MORE: How to Use Reverse Pressure Softening During Engorgement }

Brief Warm Compresses

Another way to help your baby express milk is to use moist warmth for a few minutes before nursing. This can be accomplished with a warm, wet towel, a warm shower, or by immersing your breast in a bowl or sink filled with warm water. It is important to avoid using warmth for more than a few minutes, as it can result in an increase in swelling and inflammation.

Cold Compresses 

Between nursing sessions, it may be helpful to use cold compresses of ice packs over a layer of cloth. Use the compresses for 20 minutes on and 20 minutes off, repeating as needed.

Remove the Milk

It is important you remove the milk and not let it sit in your breasts, which can led to plugged ducts and mastitis.  I found that when I was engorged just nursing alone did not remove enough milk and I still felt uncomfortably full. There are several ways to remove the milk including hand expression, a hand pump or a quality electric pump.  When using an electric pump, it should be set to a low setting, since engorged breast tissue is more sensitive and likely to become damaged with higher settings.  Lactation consultants also recommend removing just enough milk to feel comfortable.  Avoid excessive manual removal of milk, which will cause an oversupply.

Finally, the most important way to remove milk is to allow your baby to nurse every 1 1/2 to 2 hours and as long as possible.

Engorgement typically lasts for 12-48 hours with proper treatment and 7-10 days without treatment.  If symptoms have not subsided within a few days contact your physician or a lactation consultant.

{ MORE: Why the Lactation Consultant Will Be Your Best Friend }

As a new mom what early breastfeeding challenges have you faced?  If you are expecting, what are some of your concerns when it comes to breastfeeding?

{Related: How to Handle Engorgement}

What do you think?

How to Reduce Postpartum Breast Engorgement

Mindi is a working mom with three boys ages 4, 2, and an infant (born June 2013). She spent her first 8 years of her career in Speech-Language Pathology at a Children's Hospital. She currently works with adults and children in home health. The real fun for her happens when she is at home with her boys, chasing them around and pretending to be a super hero. She blogs about life as a working mom at Simply Stavish. Her weekly feature, Words in the Sand, teaches parents how to grow their child's s ... More

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3 comments

  1. LIZ says:

    tnx so much for this 🙂

  2. kimbro09 says:

    Interesting article!

  3. Maria says:

    this is very helpful

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