Engorgement is a natural process that usually happens 2-6 days after birth and is your milk coming in. Engorgement is when a mother's breast size and fullness increases as her hormone levels change and her milk production increases. It is important to note, that mothers do have milk in the first days after birth, but it is generally colostrum which is rich in nutrients and very dense so that only small amounts are needed until her milk increases in volume and the baby needs to feed on larger amounts.
Engorgement can mean that breasts are a little tender and swollen. Engorgement does not always just happen around days 2-6, and simply refers to the swelling of the breast due to the increased volume from the mother milk supply. Swelling can occur at the breast up to the collarbone and underneath the arm, it may be in one breast or both breasts, it generally a large swollen area that is tender to touch. It is important as a mother to understand what engorgement is and to be prepared for it, as engorged breasts that do not reduce can cause other problems for both mother and baby that can be painful and stressful, but can easily be avoided. Most commonly a mother may become engorged, the breast will swell, but this swelling can flatten the nipple, which in turn makes feeding more difficult for the baby, who will in turn suck incorrectly, leading to nipple damage and a hungry baby. Other problems that occur due to unrelieved engorgement is pain due to the pressure from the swelling.
The good news is that there are a range of treatments available as well as precautionary measures that can help you avoid these problems all together. Before you become engorged teach your baby to latch – This is probably the most important thing that you can do to prevent problems associated with engorgement. In the first few days after birth, you will have a very dense milk called colostrum, it is important at this time to teach your baby how to latch-on correctly. At his time your breast are softer and your flow will not be as strong, so you will be able to train your baby much more easily. Room in with your baby, this will help your breast become attuned to your baby’s needs nurse often, do not let your breast become engorged, this includes night time. Make sure that you empty both breasts and do so for an adequate amount of time nurse using skin to skin contact wear a supportive bra (no underwire) use a hospital grade pump to empty your breasts if baby is having problems feeding. Do not over pump as this will make the problem worse.
When you are engorged you can hand express or pump, note it is important to not over stimulate the breast as this can lead to oversupply and make the problem worse. Hand express a little before your baby feeds, so that they can get a better latch on If you are using a pump use a hospital grade pump to prevent damage. Do not limit your feeding to 10-15 minutes as this is not enough time for your baby to empty your breasts. Get help from an IBCLC as a correct latch will help the fix your problem and avoid complications. If you are in pain, use a cold press between feedings to relieve the pain massage your breasts before,during and after. Here is a great video link on breast massage: https://vimeo.com/65196007.
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