Managing Engorgement

What is Engorgement?

Painful swelling of the breasts as they fill with milk, lymph fluid, and extra blood in the veins.  


It often occurs in the first 2 weeks after baby is born, as your milk "comes in".  


It can occur any time during your breastfeeding journey if the breast is not emptied well.  


 If you are hurting, it means there is a problem.  If you don't address the problem, it can get worse.  You can get plugged ducts, mastitis, blebs, or an abscess in your breast.  


 Prolonged engorgement can decrease your milk supply because the milk making cells are squished for too long. 

Basic 4 steps to resolve engorgement:

1. Apply heat for 5-15 min before feeding.  A hot shower, warm packs, a bowl of warm water that you can immerse your breasts in, a heating pad.... anything that can make your breasts toasty warm (not hot). 


2. Hands on time: 

     A. Massage your breasts with quarter sized circles, starting at the top of your breast and working around the breast as if you were massaging the numbers on a clock.  Work around and around from the outer area to the areola. 

     B. Feather stroke from your cleavage to your armpit, in every possible direction around and up. 

     C. hand express until your areola is soft. 


3. Feed your baby.  Compress your breast while you feed to help the milk to move out of you and into baby. (If your baby can't latch because the nipple is too difficult for baby to grasp, you can pump for a minute or 2 to draw out the nipple.)


4. Cold pack for 5-15 min: Use a bag of frozen peas, a sock with frozen rice in it, a diaper filled with cold water....  

What else can I do?

Reverse Pressure is very helpful to clear swelling out of the areola. 

Make a V with your fingers, place your nipple in the smallest area at the bottom of the V, and press in towards your back.  Hold for 1 minute, then rotate the direction of your fingers and repeat the process.  Having someone else pushing against your hand often makes this more effective. 


Pumping after baby feeds is sometimes needed, but remember that the more milk you take out, the more you make.   Pumping can inadvertently help you have a supply for twins.  Hand expressing the leftover milk after baby feeds might be more helpful in relieving the painful pressure. 


You can also have myofacial release, or lymphatic drainage therapy done if engorgement is not resolving.  Contact Mary to find out more about this.