Breast engorgement, also known as early postpartum engorgement, refers to the swelling of the breasts that occurs shortly after childbirth. This phenomenon occurs as your body transitions from the initial stage of lactation, which begins during pregnancy, to the subsequent stage.
The second stage commences a few days after giving birth, signaling the onset of milk production. As your body prepares to increase milk production, it boosts blood and lymph flow to the breasts, resulting in a buildup of fluid between breast tissues, leading to discomfort and other symptoms.
The encouraging aspect is that early postpartum engorgement is transient in nature. Typically, it reaches its peak, characterized by the most severe symptoms, around five days post-delivery. By the time you reach the two-week mark postpartum, engorgement tends to alleviate. Employing established methods can help alleviate discomfort during this period.
Symptoms and Causes
What does an engorged breast feel like?
When experiencing breast engorgement, you may observe:
- Swelling in both breasts, particularly in the lower regions, farthest from the chest.
- Breast pain, sometimes intense.
- Breasts feeling firm or hard.
- Occasionally, symptoms such as sweating, fever, and chills. These alterations typically manifest around three to five days after childbirth. In certain instances, engorgement may not commence until postpartum days nine or 10. Engorgement can also occur whenever there’s a disparity between milk production and its removal. This explains why it’s more prevalent among those who use a breast pump, as they aren’t relying on their baby to signal when milk removal is needed.
During breast engorgement, your baby may find it challenging to latch on for breastfeeding (or chestfeeding).
If you experience a fever or chills, you might assume it’s indicative of an infection. However, this isn’t always the case. These symptoms can arise due to breast inflammation, which can have systemic effects on the body. Nevertheless, inflammatory or bacterial mastitis, which may follow inflammatory mastitis, can present with similar symptoms. Mastitis typically progresses over several days and is characterized by warmth and redness in the breast.
Therefore, it’s crucial to consult a healthcare provider if you notice any changes in your breasts. They can determine the underlying cause and provide appropriate management.
Read Also: Starting a dairy free breastfeeding diet: 4 amazing guidelines to follow
What causes breast engorgement?
Breast engorgement results from an elevation in the volume of blood and lymph (a clear, watery fluid) within your breasts. Healthcare professionals refer to this increased blood flow to a specific body area as hyperemia. In the context of lactation, there is an augmented blood flow to the breasts to facilitate milk production. Lymph plays a crucial role in supplying essential nutrients to cells and tissues while eliminating waste products. The surplus of these fluids can induce swelling in the breasts, contributing to discomfort.
How is breast engorgement diagnosed?
Breast engorgement is a transient state that healthcare professionals, such as obstetricians and midwives, can diagnose through a physical examination. Your provider will assess your breasts and engage in a discussion about your overall well-being. They will inquire about your breastfeeding experience and any challenges you may be encountering.
This comprehensive evaluation allows your provider to ascertain whether engorgement is the root cause of your symptoms or if there’s another underlying issue, such as ductal narrowing (blocked milk ducts) or mastitis.
What are available breast engorgement treatments?
Your healthcare provider will discuss various strategies for managing engorged breasts. Some options include:
- Avoid over-pumping: Continue pumping or breastfeeding based on your infant’s demands.
- Take ibuprofen and acetaminophen: Adhere to your provider’s recommendations regarding medication usage for pain relief.
- Apply cold packs: After breastfeeding, applying cold packs to your breasts can help alleviate inflammation.
- Consider manual lymphatic drainage: Your provider may perform manual lymphatic drainage or lymphatic drainage massage to enhance lymph flow in your breasts, reducing swelling. This gentle massage involves small circles in the armpits and above the clavicles, followed by gentle sweeping motions from the nipple into the armpit and clavicle area where lymph nodes facilitate fluid drainage. Your provider can also demonstrate how to perform this technique at home.
- Explore reverse pressure softening: By applying gentle, consistent pressure around the areola, fluid is directed away from the nipple, facilitating easier latching for your baby. Your provider will demonstrate this technique, and you can continue it independently as advised.
- Try breastfeeding in the side-lying position: This position may enhance comfort for your baby when latching onto engorged breasts.
- Avoid excessive breast massage: Unless directed by your provider, refrain from vigorous breast massage, as it can exacerbate symptoms. Your provider will recommend gentle pressure techniques instead.
- Wear a supportive bra: Contrary to a common myth, wearing a supportive bra won’t cause mastitis. Proper support is vital during this period, as a well-fitting bra can help maintain fluid movement in the breasts. Your provider can offer guidance on suitable bra types.
Implementing these strategies can help alleviate discomfort and manage breast engorgement effectively.
Can I pump to relieve engorgement?
Contrary to common belief, pumping to alleviate engorgement can exacerbate symptoms. The notion that continuous feeding or completely emptying the breasts is necessary to treat engorgement is a misconception. When you completely drain the breasts of milk, your body reacts by producing more milk, perpetuating the swelling rather than alleviating it.
Your healthcare provider may recommend using a manual pump (not electric) to extract only a small amount of milk, or suggest hand expression as an alternative. Removing a small quantity of milk may provide relief, but it’s important to adhere to your provider’s instructions. Avoid excessive pumping or complete breast emptying as it can worsen engorgement.
Conclusion
Effectively managing engorgement while breastfeeding requires a nuanced approach that dispels common myths and adopts gentle, targeted strategies. Understanding that continuous pumping or complete breast emptying exacerbates symptoms is pivotal. Instead, utilizing methods such as manual lymphatic drainage, reverse pressure softening, and breastfeeding in side-lying positions can offer relief.
Importantly, adhering to healthcare provider guidance regarding medication, bra support, and the cautious use of manual pumps or hand expression is paramount. By adopting these tailored approaches, mothers can navigate engorgement with confidence, ensuring a more comfortable breastfeeding experience for both themselves and their infants.
