Engorged breasts
Mon, Jun 30, 2008
The Star
BY: Dr Nor Ashikin Mokhtar
One of the most common problems women face during breastfeeding is breast engorgement.
This condition is so painful and frustrating that many women who suffer from it usually stop breastfeeding too soon.
However, there are several practical methods of preventing and treating engorged breasts. Surprisingly, you will find that a lot of these methods stem from age-old wisdom practised by our mothers and their mothers before them!
A new mother's breasts become engorged when they are overfilled with breast milk.
Normally, your breasts start making milk two to five days after your baby is born (the milk produced before that is called "colostrum" and your breasts are still soft then).
During these early days, you may feel some breast fullness and tenderness because your breasts are filled with milk, extra blood and fluids, while your baby has not yet settled into a regular feeding routine.
If you have to miss a feeding session,
express the milk by hand or with
a breast pump.
Once you have established a regular nursing routine, the feeling of fullness should go away.
However, some women go on to experience overly swollen breasts. There are several reasons this may occur. If you have established a regular nursing pattern, but you do not breastfeed as usual (due to change in routine, illness or baby starting complementary feeding), your breasts will fill up with milk and become swollen.
Of course, if you suddenly stop breastfeeding your baby altogether, engorgement will also occur because there is too much supply of milk.
Breast engorgement can be more severe if a mother waits too long to start breastfeeding, does not breastfeed often enough or gives her baby formula milk or water (baby is less likely to fully empty the breast while nursing).
It's hard to miss the signs of engorged breasts, but besides the obvious breast swelling and pain, look out for other signs like slight lumpiness, warmness, flattened-out nipples, hardened areolas (the dark area around the nipples), slight fever and swollen lymph nodes in your armpits.
If the breast engorgement is severe, it can lead to other complications and affect your baby's nursing.
As your nipples become flattened during engorgement, it can be difficult for baby to latch on to your breast properly. At the same time, baby's attempts to latch on will cause your nipples to become sore and cracked.
All this means that you will be less inclined to breastfeed, and your breasts will continue to be engorged with milk. If this goes on without treatment, your milk ducts may become blocked and infected, causing breast infection (or "mastitis").
Worst of all, your baby will not be getting enough milk throughout this period.
But don't worry - as I mentioned earlier, there are ways to prevent engorgement and treat it if it does occur.
Here are some tips to help you prevent breast engorgement. These involve managing the "supply and demand" of your breast milk.
Start breastfeeding as soon as possible after birth.
Breastfeed whenever your baby shows signs of hunger. If possible, breastfeed eight to 12 times within a day, to prevent milk from accumulating.
Make sure that baby latches on properly, so that he or she will feed well.
Empty your breasts completely every time you breastfeed. This will help your milk move freely, keeping your milk supply at the level your baby needs.
If your breasts are hard and swollen, express some milk out to soften your nipples before putting your baby to the breast.
Do not use bottles or pacifiers while you are exclusively breastfeeding baby.
If you have to miss a feeding session, express the milk by hand or with a breast pump.
When you plan to start baby on complementary foods (after six months), introduce the solid foods gradually, while continuing to breastfeed baby.
Most importantly, if you face any problems with breastfeeding, seek the advice of your lactation consultant, nurse, paediatrician or obstetrician. Dont be afraid to ask questions.
The first thing to remember is that mild to moderate engorgement is normal and will often resolve by itself within 12 to 24 hours.
However, if your breasts do not soften after a few days, or after a feeding, try some of the home remedies described below.
Before each feeding, apply some warm, moist heat (with a warm cloth or compress) on the breasts for a few minutes, or take a short, hot shower. This will help the milk to flow - but do not apply heat for more than five minutes, because it may make the swelling worse.
Massage both breasts gently and express a bit of milk (by hand or with a pump) before feeding, and while the baby pauses during feeding.
After feeding, a cold compress will help to reduce swelling. You've probably heard your mother or relatives talk about using green cabbage leaves - yes, it works! Wash some chilled cabbage leaves, crush them or cut the top of the leaf veins to fit them to the shape of your breasts, then put them over both breasts for about 20 minutes after feeding several times a day.
Some women even use cabbage leaves during the early days of breastfeeding to prevent engorgement.
As engorged breasts can feel extremely tender, be sure to wear a well-fitted, nursing bra for good support during this period.
If the pain is unbearable, ask your doctor whether it is safe to take medications such as ibuprofen.
Your doctor or lactation nurse may also be able to teach you breast massage and relaxation techniques to help improve your milk flow.
Lastly, if you have a fever or severe pain in the breasts, you may be having an infection. Don't hesitate to see your doctor immediately.
People may suggest all sorts of remedies to you, but ask your doctor for advice first, as some home treatments and traditional practices may bring more harm than help.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). For further information, e-mail
www.primanora.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care.
