Tips for treating engorgement


Tips for treating engorgement

Before nursing

  • Gentle breast massage from the chest wall toward the nipple area before nursing.
  • Cool compresses for up to 20 minutes before nursing.
  • Moist warmth for a few minutes before nursing may help the milk begin to flow (but willnot help with the edema/swelling of engorgement). Some suggest standing in a warm shower right before nursing (with shower hitting back rather than breasts) and hand expressing some milk, or immersing the breasts in a bowl or sink filled with warm water. Avoid using warmth for more than a few minutes as the warmth can increase swelling and inflammation.
  • If baby is having difficulty latching due to engorgement, the following things can soften the areola to aid latching:

While nursing

  • Gentle breast compressions and massage during the nursing session can reduce engorgement.
  • After nursing for a few minutes to soften the breast, it may be possible to obtain a better latch by removing baby from the breast and re-latching.

Between feedings

  • If your breast is uncomfortably full at the end of a feeding or between feedings, then express milk to comfort so that the breasts do not become overfull.
    • Hand expression may be most helpful (though obviously second to breastfeeding) as this drains the milk ducts better.
    • Mom might also use a hand pump or a quality electric pump on a low setting for no more than 10 minutes (engorged breast tissue is more susceptible to damage).
    • Massaging the breast (from the chest wall toward the nipple area) is helpful prior to and during milk expression.
    • It's not good to let the breasts get too full, but you also don't want to overdo the pumping, as too much pumping will encourage overproduction. If you do need to express milk for comfort, your need to express will likely decrease gradually over time; if it does not, then try gradually decreasing the amount you express.
  • Use cold compresses (ice packs over a layer of cloth) between feedings; 20 minutes on, 20 minutes off; repeat as needed.
  • Cabbage leaf compresses can also be helpful.
  • Many moms are most comfortable wearing a well fitting, supportive bra. Avoid tight/ill-fitting bras, as they can lead to plugged ducts and mastitis.
  • Talk to your health care provider about using a non-steroidal anti-inflammatory such as ibuprofen (approved by the American Academy of Pediatrics for use in breastfeeding mothers) to relieve pain and inflammation.

AVOID:

  • Excess stimulation (for example, don’t direct a shower spray directly on the breasts).
  • Application of heat to the breasts between feedings. This can increase swelling and inflammation. If you must use heat to help with milk flow, limit to a few minutes only.
  • Restricting fluids. This does not reduce engorgement. Drink to thirst.

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