Cause:
Milk production begins 1-5 days after
delivery, depending upon which baby this is for the mother. The fluids
necessary for milk production are carried to the breast through the
blood and lymph system. This increased supply of fluid collects in the
breast tissue causing the breast to swell. Early, frequently feedings
will relieve the swelling and soften the breasts. When feedings are
infrequent, delayed or missed, engorgement occurs. The breasts may be
swollen, hard and painful.
Recommended Treatment:
-
Put ice packs on the breasts between
feedings. Bags of frozen peas wrapped in a wet washcloth work well.*
-
Hand express or
pump a small amount of milk or
colostrum to soften the breast and position the baby correctly. A
warm shower or tub bath or soaking the breasts in a pan of warm
water may make milk expression easier.
-
Breastfeed every 1 1/2-3 hours during
the day and every 2-3 hours at night. To increase the flow of milk,
gently massage the breast in a circular pattern while the baby is
nursing, using the flat part of your hand. If your breasts are still
full, hand express or pump to relieve fullness.
-
Wear a bra for comfort and support.
Avoid bras that are too tight or bind, making it difficult to
relieve fullness and soften the breasts. Avoid bras with underwires.
-
Do not use a nipple shield. It
decreases nipple stimulation, milk production and milk release.
To Prevent Engorgement:
-
Breastfeed as soon as possible after
birth.
-
Breastfeed every 1 1/2-3 hours during
the day and every 2-3 hours at night.
-
Breastfeed as long as the baby wishes
on the first breast before offering the second breast.
-
Offer both breasts at every feeding.
-
Begin each feeding on the breast
offered last.
-
If you delay or miss a feeding or the
baby nurses poorly, hand express or pump to relieve fullness.
*Some
women choose to use cold, raw, cabbage leaves on the breasts after each
feeding to relieve engorgement. Why cabbage leaves relieve engorgement
is unclear. There may be a substance in the leaves which decreases
swelling or it may be the temperature of the leaves. Rinse the leaves
well in cold water before use. Place the leaves on the breasts with the
nipples exposed until the leaves wilt (15-20 minutes).
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