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Engorgement and How to Handle It

Engorgement is a normal part of the milk production process, but it can cause problems for your breastfeeding journey if ignored.

When you’re expecting, you expect that your breasts will change during pregnancy. And that they’ll also change if you breastfeed.

How they’ll change, though, isn’t really something that gets talked about. That omission can leave parents surprised—shocked, even—at some of the things that happen with our breasts.

One of the biggest—literally—and most surprising changes is engorgement.

What is Engorgement and Why It Happens

When your breasts become full—overly full!—of milk, that’s known in the breastfeeding world as engorgement.

Engorgement of breasts is a normal part of the early breastfeeding process. Your breasts start making milk well before your baby is born. (As early as 16 weeks!) But this milk isn’t the copious mature milk that parents think of when they think about breastfeeding. It’s the small amounts of colostrum, the sticky, gold substance that’s perfectly developed for newborns.

Once you’ve delivered your baby, your body gets the go-ahead to start making milk. While colostrum is ready and waiting for your baby, mature milk takes between 2-5 days to come in.

(This timeline varies from parent to parent; parents who have c-sections may have a delay in their milk.)

For some parents, milk comes in gradually, but for others, especially first-time parents, the arrival of mature milk is characterized by a distinct breast fullness, heaviness, warmth, and leaking milk.

You may also notice that:

  • Your breasts feel hard—some breastfeeding parents say their breasts feel as hard as a rock.
  • Your skin looks and feels tightly stretched or shiny.
  • Your breasts ache or throb.
  • Your areola feels taut or hard and that your nipple flattens.

In other words, you’re experiencing engorgement.

How long does it last?

While engorgement is normal, it’s not exactly comfortable for breastfeeding parents and can make nursing more challenging for babies depending on how engorged your breasts get.

Assuming that a parent is planning to exclusively breastfeed and that they’re able to start breastfeeding right away, initial engorgement is relatively short-lived—if experienced at all. Remember, not all breastfeeding parents get engorged when their milk comes in. Those that do, though, typically only experience engorgement for 12-48 hours after their milk comes in.

Engorgement After Your Milk Comes In

Engorgement isn’t limited to when milk comes in. It can happen as breastfeeding parents establish their milk supply. During the first 6-12 weeks of breastfeeding, it takes time for hormones to regulate and supply and demand breastfeeding to balance out. As such, your body might over anticipate how much milk your baby needs, leading to engorgement.

But, truly, engorgement can happen anytime your breasts are overfilled with milk.

These situations might be caused by:

  • Missing or skipping a nursing or pumping session
  • Clogged milk ducts
  • Mastitis
  • Weaning
  • Oversupply (also known as hyperlactation)

How do you deal with engorgement?

The best way to prevent engorgement is to nurse or express milk often. That being said, there are a couple of factors that come into play.

  • If you nurse or pump too much in response to engorgement, you can create an oversupply
  • Not nursing or pumping enough, though, can diminish your milk supply
  • Ignoring engorgement can also lead to clogged ducts and mastitis
  • So how do you balance relief from engorgement with protecting your milk supply and preventing other breastfeeding problems from occurring? The following tips can help.

Feeding baby

  • Feed your baby on demand and often. Aim for 8-12 feeds a day.
  • Don’t limit your baby’s time at the breast.
  • Wake your baby for a feed if your breasts are full and uncomfortable. This practice is especially important at night, little babies need nighttime feedings and skipping nighttime feeds can negatively impact your milk supply.
  • Make sure your baby is positioned and latched correctly so they can fully drain all the milk from your breasts.

Managing discomfort

“When dealing with engorgement discomfort, remember that with management you will feel better soon!” says Nest Collaborative IBCLC, Robin Williams.

Start managing your symptoms with the following tips:

  • Use breast massage to help increase circulation in your breasts and encourage milk flow. You can do this both before and during breastfeeding.
  • Apply a warm, damp compress to your breasts, or take a warm shower for comfort and to help milk flow.
  • Hand express a small amount of milk before breastfeeding so your baby can latch more easily.
  • Avoid constricting clothing and avoid wearing a bra.
  • Apply a cold compress or a chilled, washed cabbage leaf to your breast to reduce inflammation.

If your breasts still feel full, you can express milk after a feed. However, talk with an IBCLC about the best approach to doing this so you avoid oversupply.

Engorgement in breastfeeding is usually a temporary issue, but it’s important to learn how to handle it properly. Book a convenient video consultation with a Nest Collaborative IBCLC to learn tips and tricks for making you and your baby more comfortable.

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