How to Relieve Breast Engorgement?

What is breast engorgement?

Breast engorgement is a pathological increase in the mammary gland, characterized by breast hypertrophy, resulting in swollen, tense, and painful breasts, making breastfeeding difficult. It's a common reason for early breastfeeding cessation, highlighting the importance of early intervention.

Untreated, breast engorgement can lead to mastitis, an inflammation of the mammary gland (milk stagnation in the lactiferous ducts creates a breeding ground for bacteria).

Breast engorgement shouldn't be confused with the physiological increase in mammary gland size related to milk production in the first few days postpartum. Some breast fullness and mild pain are normal during this phase.

Symptoms of engorgement due to breastfeeding

While physiological breast swelling is due to milk production in the early postpartum days, engorgement stems from milk accumulation in the alveoli (tiny milk containers). These swell and then rupture, causing breast edema. The breasts become swollen, tense, shiny, and painful. The areola (the darker area around the nipple) and nipple itself can be affected, retracting and making latching difficult for the baby.

The breast feels swollen, red, painful to the touch, and hard, hindering the baby's ability to latch due to the lack of suppleness. Milk flow is also impeded. A fever may occur, but it usually remains below 38°C (100.4°F).

How to prevent breast engorgement?

Consider these tips to prevent breast engorgement:

• Breastfeed early, often, and on demand to promote good milk drainage;
• Completely empty one breast before offering the other;
• Find a calm place to breastfeed;
• Relax with a warm shower, warm compress on your back, calming breathing exercises, or a warm drink;
• Gently massage the areola and nipple to encourage milk flow;
• Breastfeed your baby at the first signs of hunger, before they become overly distressed and cry, to facilitate better latch;
• Encourage skin-to-skin contact;
• Ensure correct baby positioning during feeding;
• Confirm effective sucking and swallowing;
• Use breast compression if latch is poor (hold the breast in a "C" or "U" shape, compressing during less effective sucks and releasing during swallows);
• If breasts remain full and tense after feeding, manually express residual milk and apply a cold compress for a few minutes (avoid direct skin contact!);
• Wear a supportive, non-restrictive bra;

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How to relieve engorged breasts?

If you experience breast engorgement, don't panic. Experts recommend:

• Breastfeed very frequently, at least 8-10 times a day, including at night, until engorgement subsides;
• Use analgesics under medical supervision, if needed;
• Thoroughly empty breasts at each feeding, preferably by hand (or with a breast pump if necessary);
• To empty breasts without manual expression or a pump, try the "bottle method": fill a clean, wide-necked bottle with warm water, empty, refill with boiling water, wait a few minutes, empty, and cool the neck under cold water. Place the cooled neck against the breast, creating a vacuum to draw out milk;
• Warm compresses before feeding to promote milk flow and cold compresses afterward to reduce edema can help;
• Applying cabbage leaves: Many women find cabbage leaves helpful. Ensure hygiene: wash leaves and hands thoroughly. Apply leaves (avoiding the areola and nipple) as a compress for about an hour, several times daily, only if skin is intact (no lesions).

Try the K.J. Cotterman method: lying down, gently rotate fingertips around the base of the nipple (areola) to push edema towards the breast base and top, softening the areola for better latch.