Breastfeeding - Engorgement

Many women experience engorged breasts in the early stages of breastfeeding.

What is engorgement?

• When you are pregnant, your breasts develop milk-producing structures, and begin to produce colostrum.
• 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 your baby suddenly starts sleeping through the night.
  • If your baby goes into a nursing strike.
  • If you wean your baby abruptly.

How to prevent engorgement:

• 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.

Go to:

• Breastfeeding problems and solutions.

Back to the breastfeeding main page

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