- Fullness or hardness of the entire breast
- May extend to breast tissue in the armpit
- May be painfulUsually occurs 48-72 hours after delivery, longer after a C-section
- If nursing has already been established, engorgement may occur if feedings or pumpings were skipped.
Problems caused by engorgement
- Milk won't release or let down
- Baby cannot latch on because breast is too full
- If engorgement lasts for many days, milk production may decrease
The best way to relieve engorgement is for the baby to remove the milk. Nurse the baby every 2 to 3 hours, on que, including the middle of the night.
If the baby is having a hard time latching on to the engorged breast, try using reverse pressure to soften up the areola. The idea is that you will try to push the swollen/edematous tissue closer to your chest wall and away from the nipple and areole. Use all ten fingers and surround the areola. Push the tissue against your chest for 3 minutes. You may start to see drops coming from the nipple. Once you sense that the nipple is soft, try latching the baby on or pumping.
If the baby is too sleepy or cannot nurse effectively, use a pump, every 2 to 3 hours.
If the baby and the pump cannot get milk to come out, try to express milk by hand: Place the pads of your thumb and index finger on the areola so they are about 1 and a half inches apart and the nipple is centered between them. First, press your fingers back, against your chest wall, and open your fingers up a bit so the tissue between them gets stretched a little. Then, come forward with your thumb and index finger, bringing them closer together, trying to press the milk out. Try this a number of times until you see milk coming out of the nipple. You may need to reposition your fingers closer or further apart to get the best removal spot for you.
Ice packs will provide significant relief. Make sure that you protect your skin from getting "freezer burn" by putting a protective layer between your skin and the ice pack.Ice for as long as you feel is comfortable.
Cabbage leaves can provide relief for engorgement. The reason is unknown. Take a green cabbage, separate the leaves and freeze them. Cover breasts with 2 or three leaves and change the leaves when wilted or when you remember. Some people also recommend crushing the main vein of the cabbage and placing the leaf so that the main vein goes over the nipple. Be careful not to use cabbage for more than 24 to 48 hours as it may cause a significant reduction in milk production.