- In This Feature
- Optimizing Breastfeeding
- What Are the Signs that My Body Is Making Milk?
- What Is Normal Engorgement?
- What if Normal Primary Engorgement Goes Untreated?
- What Is Abnormal Engorgement?
- How Do I Treat Engorgement?
- How Do I Build a Strong Milk Supply?
- Is There Anything That Will Interfere with My Milk Supply?
- The ABCs of Building a Milk Supply
How Do I Treat Engorgement?
During this phase of engorgement, avoid wearing a bra. A bra may compress your breasts and make your swelling worse. Sometimes clients ask me about cabbage leaves as a treatment for engorgement. Certainly, there is no harm in wrapping your breasts in cabbage, but I prefer the treatment described next. Whatever treatment you choose, it is important to repeat the regimen every two or three hours day and night until your engorgement abates and your milk is freely flowing. Until your engorgement is under control, avoid any preparations that could potentially increase your milk production and worsen your engorgement, such as herbal teas or supplements that contain the herb fenugreek.
Cold treatment: If your breasts feel very hard and full, chances are it's not just trapped milk volume that is causing the swelling. During engorgement, your breast tissue becomes over distended and painful just like a sprained wrist or ankle. It is important to reduce the swelling so that milk flow can resume. The treatment for the breast swelling of early engorgement mimics the treatment for a sprained ankle. Before doing anything else, my treatment of choice is cold treatment. When working with an engorged mother, I insist on real ice in quart-size plastic bags. The ice can be cubed or crushed. I then wrap the bags in a thin receiving blanket and cover the mother's swollen breasts with the wrapped ice bags. (I don't recommend putting ice directly against bare skin.)
Most mothers experience a noticeable reduction in swelling after fifteen to twenty minutes. Of course, the ice bags can be placed back in the freezer and reused. The cold treatment will need to be repeated until the engorgement is resolved.
Heat treatment: Sometimes a heat treatment is necessary to loosen a tight full breast. A heat treatment works best by getting into the shower and allowing warm water to soak the breast. The shower should be warm enough so that steam rises. Be careful not to burn your sensitive breast or nipple tissue. If you find heat helpful, then try wetting the inside of a disposable diaper with warm water and wrapping one around each swollen breast. Remove the diapers when the heat dissipates. Repeat the heat treatments frequently until your breast milk is freely flowing, and your engorgement is resolved.
Milk removal: Milk can be removed from your engorged breasts after the swelling is reduced by cold or heat treatments. Frequent milk removal is key to the healthy resolution of engorgement. Breastfeeding your baby often will help prevent your breasts from becoming over engorged. For this reason, it is important to keep your baby close to you, so you can easily breastfeed. Avoid substituting formula supplements in place of breastfeeding. Supplementing will reduce the number of times your baby breastfeeds and worsen your engorgement.
Engorgement can significantly change the shape of your breast and nipple, making it difficult for your baby to breastfeed. This can occur even when your baby has successfully breastfed prior to the development of primary engorgement. If you find yourself in this situation, then a nipple shield may help your baby reattach and effectively breastfeed. You can stop using the nipple shield once your engorgement resolves. If you are unable to breastfeed your baby, use a double electric hospital-grade breast pump every few hours. Pumping will protect your milk supply as it lessens your engorgement. Save all of your milk to feed your baby.