ENGORGEMENT

Engorgement occurs when there's an excessive buildup of milk in the breast. While it's normal for breasts to feel warm, heavy, and tender initially, if they become hot, painful, hard, and tight, it's abnormal and requires attention to prevent issues like mastitis and reduced milk supply. Engorgement is common in the first week after birth and can happen anytime if milk isn't effectively removed.

Watch out for the symptoms of Mastitis

PREVENTING ENGORGEMENT

  1. Ensure effective positioning and attachment, seeking help if needed.

  2. Feed frequently to prevent milk buildup.

  3. Avoid infant formula as it replaces breastfeeds.

  4. Avoid dummies, which may reduce breastfeeding frequency.

TREATING ENRGORGEMENT

It's crucial to manage engorgement promptly to prevent complications. Gently hand express some milk before feeds to soften the breast tissue, aiding effective attachment. If breasts remain full after feeds, further expression helps avoid milk stasis, reducing future milk production. Applying warmth before feeding or expressing can facilitate smoother milk flow.

SELF-HELP MEASURES

  • Ensure you feed your baby responsively, in accordance with their cues. Overfeeding from one breast or continuously pumping until the breast is empty can cause hyperlactation, which can lead to tissue swelling and inflammation. While you might come across this advice in some sources, recent research by Mitchell et al. (2022) and Douglas (2022) suggests that you should prioritise meeting your baby's needs without unintentionally making inflammation worse by increasing milk supply.

  • When your baby struggles with effective attachment to your breast or encounters feeding difficulties, incomplete milk removal during feeds may leave some areas of your breast unemptied. Enhancing your baby's breastfeeding technique can lower the risk of engorgement. Ensure that your baby is correctly positioned and latched onto your breast. If you're uncertain, don't hesitate to seek assistance from your midwife, health visitor, or a breastfeeding supporter, as even a minor adjustment can have a positive impact.

    Experiment with various breastfeeding positions.

  • Some mothers may find warm compresses comforting, and nipple warmth can assist in promoting let-down. Nonetheless, exercise caution with their use, as overly hot or frequent application of compresses could potentially escalate swelling and inflammation. Consider using cool compresses to alleviate symptoms between feeds (Mitchell et al., 2022; Douglas 2022)

  • Refrain from applying strong pressure, massaging the breast firmly, or using items like an electric toothbrush to alleviate lumps or sore areas. Such actions may lead to tissue damage and heightened inflammation, when applying pressure to your breast, it should be as gentle as stroking a cat. (Mitchell et al., 2022; Douglas 2022).

  • Aim to get as much rest as possible, as it will support your recovery.

  • Examine your clothing or any items that might be pressing against your breast. This includes your bra - some women discover relief by going without one.

  • With basic care and emotional support mother’s can continue breastfeeding. You may feel unwell, in pain, tearful, or disheartened. Continuing to breastfeed will aid in your recovery, and your breastmilk is still the best nourishment for your baby.

  • Lactating breasts can feel lumpy and painful due to normal lactational glandular tissue and hormonal changes after childbirth. Women should not be concerned about "plugging" and should be reassured that infection does not develop within a few hours. Pain and redness in the morning after a long stretch of sleep are typically due to alveolar distention, edema, and inflammation, rather than infection.

REVERSE PRESSURE SOFTENING

Reverse pressure softening (RPS) is a breastfeeding intervention that has proven very helpful in the first 14 days postpartum. It involves applying gentle, manual pressure around the areola, pushing back towards the chest wall before a feed. This helps to reduce swelling and soften the areola, making it easier for the baby to latch effectively. By pushing fluid away from the nipple, RPS facilitates improved breastfeeding and can be particularly useful in cases of engorgement or when the breasts are too firm for proper latch.

Kelly Mom Reverse Pressure Softening Technique

Reverse Pressure Softening Video


Citations:

Breastfeeding Network. (2022). BfN Mastitis Leaflet. Retrieved from https://www.breastfeedingnetwork.org.uk/wp-content/uploads/2022/12/BfN-Mastitis-Leaflet-December-22.pdf