When your baby is born, your breasts continue producing
colostrum for a while (usually twelve hours to five days).
With regular suckling, your breasts get the message that your
baby is alive and well and needs more milk. They gradually switch
to producing mature breastmilk in large amounts. This will also
happen without any nursing, but will take more time.
At the beginning, the supply-demand system of breastfeeding is
not yet established. Your breasts might start making a large
amount of milk quite suddenly.
As a result, your breasts may become overfull, rock-hard and
tender.
Later on, when you've been nursing for a while and have a
well-established milk supply, you
won't normally experience engorgement, since your breasts will
produce just as much milk as your baby needs.
However, you might get engorged if you skip feedings for any
reason:
If you are away from your baby for a number of hours and
don't express or pump your
milk.
If you practice true demand
feeding, you may never experience engorgement:
Nurse your baby as often as she or he wants.
Carry your baby in a sling. Keep your baby with you
constantly so that you don't miss cues for nursing.
Sleep with your baby. Many women
go to sleep with soft breasts and wake up with huge rock-hard
aching breasts. If you nurse several times in the night, this
might not happen to you.
In addition to nursing whenever your baby wants it, nurse
when you need or want it. If you feel your breasts
filling up, nurse your baby. It's OK to wake
up the baby to nurse if necessary.
How to treat engorgement:
Nurse your baby often.
Your breasts may be so hard and full that your baby has a
hard time latching on.
If this happens, express enough milk to soften the breast
so that the areola can be grasped easily. Then let your baby
nurse.
If your baby isn't interested, or nurses from one side and is
satisfied, pump or express the other
breast just enough to feel comfortable.
You might worry that pumping or expressing
milk will cause your milk supply
to increase even more, and worsen the engorgement problem.
If you pump or express just
enough to feel comfortable, you don't need to worry about
this.
It's much more dangerous to leave your breasts engorged, as
this may lead to plugged ducts and
mastitis.
This is particularly dangerous for bottle-feeding
mothers. The best thing to do is nurse your baby. It's
best for you and the
baby. If you can't or won't, pump or express
some milk and feed it to the baby or throw it away.
Take a warm bath or shower. Your milk will start flowing on
its own, and you'll feel great.