Breast Engorgement: How To Prevent (& Survive) This Painful Condition

Surviving breast engorgement

Despite your best efforts, engorgement may happen – no shame or blame here! Here are 4 tips on how to survive breast engorgement:

1) Continue to feed or pump often.

You may be so uncomfortable that you don’t want anything, including your baby, touching your breasts. However, not removing any milk will only worsen your engorgement. If you can’t get your baby to latch after trying to soften your breast, or your nipples are damaged and need rest, replace breastfeeding with full pump sessions every 2-3 hours (or 8-10 times in 24 hour period). Each pump session that is in place of a feed should last approximately 15-20 minutes on each breast and be done with the highest suction strength that is still comfortable. If you are cringing or crying, the suction is too high.

2) Pump or hand express to comfort, then try to latch.

Your baby is the best milk-remover, so pumping to comfort should only be 1-5 minutes long to help relieve some pressure in your breast and soften the nipple/areola enough to allow baby to latch deeply. This pumping or hand expression is not meant to replace the feed or empty the breast, just soften. Pumping too much will increase milk production, making engorgement worse, so stick to just what is necessary.

3) Reverse-pressure softening.

If you received intravenous (IV) fluid during labor, such as with an epidural or induced labor, you most likely retained water. Therefore, your breasts may be waterlogged for the first 7-10 days after delivery. If this is the case, you’ll need to push the water in your breast tissue back and away from your nipple for your baby to latch well. Here’s how to do so:

  • Put 1 pointer finger, yours or a helper’s, flat on opposite sides of the nipple base (like at the 3 and 9 position on a clock).
  • Firmly (but gently) press back toward your chest and hold for 5-10 seconds.
  • Rotate the fingers 180 degrees (to 12 and 6 on a clock) and repeat the hold. Your nipple should stand out more than before.
  • Latch your baby as quickly and deeply as possible because this is only a temporary movement of water.

4) Manage the inflammation.

Breast inflammation can put pressure on your milk ducts. Unfortunately, this added pressure can trap your milk and lead to more pressure and hardening. With this in mind, adding heat can help your overall milk flow. Try one of the following:

  • Wrapping a warm (not hot) washcloth around your breast for a few minutes before latching.
  • Adding warm water over your breasts (as in the shower or in a basin/bath) while gently massaging down the breast with flat palms.

Also, a cool (not cold) cloth after or between feedings can soothe aching and pressure. A breastfeeding-safe anti-inflammatory, such as ibuprofen, can be helpful as well.

If not corrected, engorgement can lead to mastitis (infection of the milk duct), damage to breast tissue, and a decreased milk supply. Contact a board-certified lactation consultant if you need further help working through breast engorgement.


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