Tips for dealing with engorgement
Engorgement occurs when there is more milk volume occurring on days 2-5, and typically lasts 12-48 hours, longer if not treated appropriately. During this time, breasts may feel larger, heavy, and warm. Sometimes a low grade fever can occur during this time. It can affect each individual differently, ranging from mild to severe, involving both breasts or more on one side, and can extend into the armpit. Some babies may have a hard time latching onto the areola (darker skin around the nipple) and nipple because of the full, tight skin. Here are some tips to help during this period:
Feed on demand, let the baby nurse as desired. Aim for at least 10 feedings per 24 hours
Allow baby to nurse until a contented state and empty one breast well before moving to the second breast
Ensure baby is latched well and watch for signs of good milk removal
Hearing swallows (or gulps) after every 1-2 sucks
Breasts feel full before and softer after feeding
Watch for dark bowel movements in baby to turn loose, yellow, and seedy
Urine output should increase to 6-8 wets per 24 hours, typically by day 5
If pumping breasts, empty every 2-3 hours, and use techniques to maximize milk removal
Use your hands to compress/massage breasts during pumping
Ensure the correct flange size is being used
Hand expression after finished pumping
Use of cold compress on the breasts
Use a pain reliever, like Ibuprofen, when necessary
If baby is having a hard time latching onto tissue around the nipple because of firmness, use hand expression to soften for a few minutes, and then attempt to latch
If breasts still feel full after nursing, try hand expressing some milk until you feel more comfortable; not removing milk to empty
Wear a comfortable bra, and try to avoid tight fitting bras
Ensure you are drinking plenty of fluids
Avoid heat to breasts, as this may increase inflammation and swelling
Short periods of applying chilled, green cabbage leaves may help with reducing swelling, but can potentially cause a decrease in milk production
Reach out to a lactation consultant if you are struggling with engorgement and needing some advice during this period of time.