Engorgement (swollen breasts) happens when the milk producing cells are uncomfortably full. Engorgement is sometimes apparent in the areola or the breast or both, in one breast or in both breasts. (you may have just one engorged, sore swollen breast).
When the “Milk Comes In”
Between day 3 and 5, a mother’s milk changes from colostrum into mature milk and her breasts become swollen with breast milk. Engorgement during this time is normal.
Things that can make breast engorgement worse:
• When Mom and baby are separated from each other.
• Engorgement and swollen painful breasts are more common in the first few weeks of the breastfeeding relationship.
• Engorgement is usually worse if Mom has been given IV fluids.
• When baby is given formula supplements. When is supplementation needed? Read here.
• Baby is sleepy whilst trying to breastfeed him/her. (due to jaundice or drugs given during labor) Read more on how to keep a baby awake while breastfeeding.
• When Mom follows a feeding schedule, instead of feeding baby according to hunger cues. It is recommended to breastfeed on demand.
• Timing baby on each breast during a breastfeeding session. It is recommended to allow baby to breastfeed until he/she indicates that they have had enough, then offer the other breast. When baby breastfeeds again, Mom should offer the other breast.
• If Mom has small breasts. Ladies with small breasts have a lower storage capacity, which means that they will need to feed more frequently than a lager breasted woman.
• Breasts are swollen and engorged due to a change in baby’s feeding pattern. This can happen if baby starts sleeping more.
• Women who have already had children seem to have more engorgement, but it also disappears quicker.
• Ladies who have had breast surgery (reduction or augmentation) may have engorgement problems, if the breast milk ducts have been damaged; the breast milk may not have an opening to leave the breast.
Symptoms of Engorgement
• Breasts feel huge
and swollen. The skin of the nipple and areola are stretched tight,
making it difficult for baby to latch on. This can also cause nipple
• Breasts are hard to the touch.
• Breasts are tender or painful and may be throbbing.
• The breasts are warm to the touch and red.
• Mom may have a low fever.
• Feed baby as frequently as he/she wants.
• Wake baby if baby breastfeeds less than 8 times in 24 hours.
• Avoid using artificial nipples and pacifiers.
• If at all possible, avoid using any supplements.
• A Nipple shield may be needed if baby has trouble latching on. It should only be used for short periods of time.
Mom should ensure that her breast pump flange is fitted to her size.
She can also pump a little milk before a feeding to soften the breast
for easier latching on.
• Mom should drink enough water to keep hydrated; this will prevent engorgement and mastitis.
• Symptoms of engorgement can be safely treated with Danzen and Bromelain/Trypsin complex anti-inflammatory medication.
• Apply a warm face cloth to the breast just before feeding to help the milk flow.
• Apply a cold compress to the breast after feeding to decrease pain and swelling.
Put a cold cabbage leaf against your breast for a few minutes. It is
believed that the cabbage gives off enzymes that ease engorgement, but
this is not scientifically proven.
• Ultrasound treatment can relieve pain of tender and swollen breasts.
Tracy Behr, CBC, CLD (CBI)
Course on physiology of breastfeeding / breastfeeding problems and engorgement.
Other pages on breastfeeding problems in connection with this page on "sore swollen breast"
* Swollen tender breasts leak breast milk
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