After Pregnancy

Breast Engorgement : Signs, Causes and Cure

Breast Engorgement

What do we mean by Breast Engorgement?

Colostrum, the filling of breasts with milk, starts soon after a mother gives birth. Though a cheerful moment, filled with excitement to feed your newborn, can also be a cause of swelling and pain for your breasts. Also referred to as Breast Engorgement. It can kick in within a week of delivery or any time later while you continue lactating, affecting either both breasts or just one at a time.

Many women face swelling and pain in their breasts, a few days after childbirth. This tenderness, also known as breast engorgement. It is caused by sudden increase in milk supply and blood flow levels to the breasts of a new mother.

Breast Engorgement

A few days after the delivery, a mother’s body undergoes several changes. It includes an increase in blood flow to the breasts, which helps in the production of ample milk for newborn. But this increased blood flow can often result in excessive pain and discomfort for the new mother.

The study showed that the prevalence of breast engorgement among lactating mothers was 65%-75%.

Leading Reasons Behind Breast Engorgement

Every mom is different and so are her symptoms that come with breast swelling. Even still, the key indicators on the start of engorgement are fairly common and are often seen in the form of the breasts getting heavier, tender and warmer eventually leading to redness, swelling and pain.

A new mom may not start producing milk till after a few days (3-5 days) of the delivery. And thus breast engorgement pain might kick in only after a week or so from the date of the delivery. While the little life in your arms can help relieve the pain by simply emptying your breasts. Problems arise if this little one faces difficulty latching and may indicate a call for you to take matters into your own hands, if you wish to timely manage the pain.

Many women who decide not to breastfeed, also face breast swelling a few days postpartum, which eventually stops, along with the milk production, if the mother doesn’t nurse. But for those of you who continue to breastfeed, breast swelling can reoccur at any time, thus making it all the more necessary for you to be prepared to deal with the tenderness and pain and make yourself aware of the triggers that cause breast engorgement and what you can do to avoid them.

Some of these causes of breast engorgement are:

  1. Missing a feeding or skipping pumping
  2. Sudden weaning
  3. Avoiding breast-feeding or creating an overabundance of milk for the baby by using formula to supplement nursing
  4. Breast-feeding a sick baby
  5. A baby with difficulty latching

Symptoms of Breast Engorgement

Though, symptoms of breast engorgement can vary from person to person, some common symptoms which most people observe are:

  • Tight or hardened breasts which are tender or warm to touch.
  • A feeling of full and heavy breasts
  • The breast may at times feel lumpy with pain.
  • Swelling may or may not occur in both breasts, and at times may even extend to the armpits, causing pain.
  • Veins under the skin of the breasts become more visible.
  • Fever and fatigue, during the initial milk-producing days.

While most of these symptoms are very common and a mother can continue breast-feeding with a mild ‘milk fever’, it is important to reach out to the doctor in case the temperatures start to rise, as a high fever in the mother could also be indicative of an underlying infection.

These infections, if caught on time, can be treated easily, making it necessary for new moms to keep a close eye on their body temperature. Especially during the days of breast-feeding, to avoid small infections from turning into bigger problems for both mother and child.

For example, in the case of Mastitis, it can be difficult to differentiate between the infection and breast engorgement as both display similar symptoms. Mastitis, if untreated, can lead to pus accumulation in the clogged milk ducts and thus fever monitoring is the only way to keep tabs on any sort of such infection in a new mother.

Breast Engorgement Management

There can be several methods for treatment of breast engorgement which can vary from mother to mother, based on whether they are nursing their newborns or not.

For Nursing Mothers

Those who face breast engorgement, while nursing can use the following tricks to keep the pain and swelling under bay:

  1. A warm shower or compress can go a long way in encouraging milk let down.
  2. Feeding the baby every few hours can prevent your breasts from feeling full and swollen.
  3. Massaging the breast while feeding the baby is a great way to manage the pain.
  4. Nursing the baby for as long as he/she is hungry, can work well for both mother and baby’s health.
  5. By alternating the breasts during feeding, a mother can ensure that the baby helps her empty both the breasts.
  6. If nursing isn’t feasible, it is important that the mother use a pump or hand expression, to drain out the excess milk
  7. A cold compress after feeding helps relieve the swelling as well as the pain.
  8. Over the counter pain medications can be taken, in case of severe pain, after consulting your doctor.
  9. A supportive bra that keeps the breasts in place and restricts movement can help manage the pain.

Though the breast can feel full and heavy, the typical symptoms like swelling and pain only last for about a day in new mothers, after which they should start to feel more like themselves.

For Non-Nursing Mothers

Those mothers out there, who have decided against nursing, it is not possible to prevent breast engorgement in the first few days after delivery. But over time, by teaching your body how to regulate milk production, breast engorgement can be prevented in the later stages:

  1. A new mother’s body makes milk regularly, even if she decides not to feed. It is thus necessary that she pumps out the milk every 2-3 hours.
  2. Regular use of ice packs, eventually decreases the milk supply, while calming the swelling related pain. The cool packs tend to do so by turning off the signal to produce more milk.
  3. Feed or pump regularly. Your body makes milk regularly, regardless of the nursing schedule. Nurse your baby at least every one to three hours. Pump if your baby isn’t hungry or you’re away.
  4. It is important to remove the small leftover amounts of breast milk, by either pumping or using hand expression. Given this, it is necessary to note that the pumping is in moderation. Otherwise it causes the breasts to produce more milk, in order to make up for the loss.
  5. Weaning by any mother must be done gradually, giving the body time to adjust. If done too quickly, the body might instead start to increase the production of milk, rather than when you wean slowly and give your body time to adjust to the decreased milk needs of the baby.

Even with no breastfeeding, the body naturally produces milk, postpartum. But with no use of the milk, within a few days the new mother’s body starts to adjust the milk supply for a decreased need and eventually dries up, leading to an end of breast engorgement.

Read How You Can Stop Breastfeeding In 7 Simple Ways

Preventing Breast Swelling

While postpartum feeling of uncomfortably heavy breasts is natural and bound to set in within 2-5 days after birth, it is around the 3rd-5th day after birth, when the breast starts to feel typically hard, that the engorgement is setting in. While during the normal fullness, the breast and nipular area remains soft, and the baby latching stays upbeat, with the onset of engorgement, the breast skin tightens up, and the nipples start to increase in diameter, flattening out and thus making it hard for the baby to latch-on. This is generally accompanied by a throbbing pain, warmth and tenderness that may or may not extend to the armpits.

Despite the difficulties, the good news is that these symptoms barely last for 24-48 hours (can extend to over a week, if not handled on time) and can subside within the first 12, if the new mother treats her symptoms properly, with the below mentioned techniques:

  1. Ensure that you feed your baby as regularly as 10 times in 24 hours.
  2. After every few minutes of feeding, you can move the baby and try re-latching, to keep the latch strong throughout the feeding process. Another thing a new mother could keep a lookout on are the frequency of the baby’s stool. It can indicate the amount of milk he/she may be consuming.
  3. Use a juice-jar pump for expressing the extra milk for not more than 10 minutes at a time (otherwise the engorged tissue may damage severely, thus causing more pain and taking longer to heal). This pumping technique, described below, can not only flush out the excess milk, but also help draw out the nipples and ease latching for the baby.

A: Look for an empty 1 liter glass bottle with a 5 cm opening and fill it with very hot water. Pour this water out of the jar, emptying it. Next, use a washcloth to wipe the rim and check to ensure that it won’t burn you on contact.

B:
Place the engorged breast lightly on the jar’s mouth, such that the bottle is air-tight (you can do so by leaning over the bottle placed on table, or your lap).

C:
As the air in the bottle starts to cool down, a vacuum is created in the jar, which in turn helps pull out the milk from the breasts.

D:
The steps can be repeated for the other breast and continued, till you start to feel lighter and more comfortable. If you feel any kind of discomfort, immediately remove the bottle because excessive suction can end up damaging the breast tissue.

  1. Cold compressions must be used only after the feedings and not for more than 20 minutes at a time.
  2. Cabbage leaf compress is a great way to heal the nipple areas and reduce the pain (just as they work in reducing sprain induced swelling). Moms around the world tend to prefer cabbage leaves to ice packs for breast engorgement treatment. Cabbage leaves not only help with the pain and swelling, but can also provide relief during weaning or in general, to reduce the overproduction of breast milk. Cabbage leaves can be put it use by following the steps mentioned below:

    A:
    Chill the cabbage leaves, by putting them in the freezer.

    B:
    Wash the leaves and apply them to the breasts in-between feedings. For engorgement and oversupply reduction, use the leaves not more than 3 times a day, for a maximum of 20-minute stretches. The use must be stopped immediately after the swelling or supply of milk reduces. While in the case of weaning, the cabbage leaves can be used on the breasts, till they wilt away and replaced with new ones as often needed.
  3. A traditional fenugreek seed poultice treatment can also be used for treating the swelling. Simply follow the given steps:

A: Step a few ounces of fenugreek seeds in warm water overnight.

B: Remove the seeds in the morning and crush them. After they are mashed, place them on a clean cloth piece.

C: This cloth piece then in turn can be warmed and used as a plaster on the breasts to treat any sore red spots caused due to engorgement or mastitis.

Alongside the above-mentioned techniques, its pivotal that the mother, avoids the aforementioned scenarios:

  • Excess stimulation of the breasts should be avoided at all costs, to prevent damage of tissue. Thus, a direct shower spray over the breasts isn’t such a great idea during the lactation period.
  • If you are using heat compressions to increase and regulate the milk flow, ensure that you do so only for a few minutes because heat compress can cause inflammation and your breasts to swell up.
  • Avoid lowering your fluid intake as it might only add to your breast engorgement. The more hydrated you stay, the better are your chances of handling the symptoms.

Conclusion

Breast engorgement is a natural reaction of the body to milk production after delivery. It can cause swelling and pain and become intolerable, if not treated effectively. Until your body understands how much milk you need to produce, it will keep causing discomfort. And thus the only way to beat it by creating  nursing and/or pumping routine for your body to adapt to.

All the methods mentioned above are great success amongst new mothers and have proven to be helpful in some way. Despite this, it is necessary that you, as a new mom, reach out to a lactation expert if you continue to experience the painful symptoms for a long duration of time. Also, keep in mind to call the doctor if you develop a more than mild fever or the engorgement doesn’t reduce within 3-4 days of developing.

Watch out for this space for more information or health tips on a safe and healthy pregnancy journey.


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Arshiya
Arshiya Ojha is an experienced technical and blog writer, who has contributed to various medical blogs, also related to traveling, mental health issues, software designing, to name a few. A strategist by profession, Arshiya has designed and executed a variety of corporate marketing plans for both the government and the private sector.

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