Breast engorgement (or overfilling with breast milk) is one of the post-partum problems affecting women widely. A woman’s breast fills with milk at most 3 days after birth. This causes pain.
This is a normal physiological process. As it occurs, the breast becomes swollen, enlarged and painful.
Normally the breasts are not sore or hard. In a majority of the women, engorged breasts usually occur two weeks after birth.
It is hectic and discouraging to deal with the problem and a newborn at the same time. Research shows that some women with this problem do not initiate breastfeeding beyond the first week after birth.
Meaning of engorged breast
Breast engorgement simply means that your body is producing more milk than your baby consumes. In other words, this is the overfilling of the breast with milk without emptying.
The breasts feel hardy, lumpy and are in most cases swollen. The fullness of the breast is due to the extra blood and fluids in the breast tissue. Engorgement is likely to occur when:
- You suddenly stop breastfeeding
- The first milk(colostrum) comes in immediately after birth
- The baby stop breastfeeding or reduces the frequency of breastfeeding
Primary breast engorgement occurs few days after the birth of the baby while secondary occurs later when a woman is not breastfeeding as often as before.
Common symptoms include:
- Firm, swollen and painful breasts
- Flat nipples with film areolar
- Fever or hotness of breast
- Swollen lymph nodes
Why are my breasts engorged?
There are several reasons why your breasts could be engorged. Here are the common causes:
During pregnancy, the body produces estrogen which results into breast tissue tenderness. The presence of estrogen in the body causes water retention hence penetration of some of it to the tissues.
2. Breast cancer
Breast cancer is the most rampant type of cancer during pregnancy and breastfeeding. In an event of breast engorgement as a result of breast cancer, an examination should be able to reveal small masses that are immovable.
3. Poor positioning
The correct techniques for breastfeeding include baby alignment and positioning. If for instance, a poor criterion for breastfeeding is employed, then engorgement might occur.
It is advisable that the baby latches well on the breast for effective breastfeeding to occur. Once engorgement occurs, the entire breast tissue, nipple and areolar might be affected, making it even much difficult for the baby to latch.
Menopause is a period that marks the end of childbirth in women. Breast swelling during menopause is as a result of hormonal imbalance.
Estrogen and progesterone levels vary in several ways. When estrogen withdrawal occurs, the breast becomes tender or engorged.
5. Augmentation mammoplasty
This is a surgical procedure which entails breast lifts, breast tissue enlargement, and nipple repositioning.
This breast manipulation procedure exerts pressure on the milk ducts causing the blockage. Inflammation of the breast tissue occurs as a result of plugged milk ducts.
Mothers who have undergone such a procedure are at risk of milk reduction and infection.
Here’s a picture illustration of engorged breasts.
Engorged breasts but not breastfeeding
I have engorged boobs but am not breastfeeding, what could be the cause? Estrogen and progesterone hormones cause breast tenderness during a period and early pregnancy.
During pregnancy, the increase in blood circulation leads to fullness of breast tissues.
- Sore engorged boobs are generally, an early sign of pregnancy and continue until the third trimester whereby it stimulates the breast to enlarge in preparation for breastfeeding
To be sure if your engorgement is due to period or pregnancy, take a home pregnancy test 14 days after your missed period. A negative pregnancy test after 14 days will prompt you to visit your doctor for more tests and examinations. There could be an underlying health problem.
Breastfeeding and engorged breasts
Breastfeeding with engorged boobs can be a nightmare. Here are tips to help you keep your breast milk flowing.
- Soften your breasts before feedings. A warm compress for a couple of minutes before you breastfeed will do you good. Or you can make use of your hands or a pump to express a small amount of milk from both breasts.
- Try to breastfeed more often. Pump your breasts if your baby won’t breastfeed. Take care to empty your breasts each time. Emptying your breast will help relieve the symptoms of engorgement.
- A painkiller such as Ibuprofen is safe for breastfeeding moms when taken as directed. But it’s a good idea to consult your doctor before you take any medicine while breastfeeding.
- If your breasts still feel uncomfortable after nursing, try a cold compress to reduce swelling. You can use a frozen wet towel, a cold pack, or a bag of frozen vegetables. Apply it to your breasts for 15 minutes at a time every hour as needed. To prevent damage to your breast tissues place a thin cloth between your breast and the cold pack.
Engorged breasts after weaning
Sudden weaning of your baby might lead to severe breast problems. This should be a gradual process to help your body reduce the amount of milk it produces as a result.
The best way to wean your baby is to reduce the frequency of breastfeeding day by day until you can breastfeed no more. This exercise should take place for about eight weeks, to help your body adapt appropriately.
How long does it last?
The good news is engorgement subsides pretty quickly for a majority of women. You can expect it to ease up in 2 to 3 days if you are breastfeeding well or pumping at least every two to three hours.
If not treated, engorgement can take up three weeks before it fully subsides.
Once the swelling subsides, your breasts will be softer, although still full of milk. You may also need a pump to reduce pressure on your breasts, even when you are not nursing because engorgement may worsen in such a case.
In severe engorgement, breastfeeding becomes impossible. Management of the pain is more of conservative that medical. Most of the treatments can be done at home by doing the following to help relieve engorged boobs.
- Use breast shells
Wearing breast shells for about 20 minutes before breastfeeding could reduce the pressure and help the nipple avert.
Breast shells encourage the breasts to empty hence alleviating the pain and tightness of the breast.
- Thermal treatment
The main objective of this initiative is to reduce congestion of milk in the breast tissue by encouraging fluid and blood flow.
Application of heat for longer periods is discouraged, as it could lead to increased swelling. If you find heat treatment unbearable, then you can use a warm spray over your breasts to help let down milk easily.
- Adjustable automatic breast pump
This type of pump is effective in removing the milk gently without putting the breasts at a risk of further engorgement. To avoid more pain, you are advised to be gentle and calm during the process of breast milking.
- Supportive bra
To help alleviate pain, the breasts have to remain almost immobile. A fitting bra is able to compress the lower segment of the ribcage, this helps in trapping milk in the lower milk ducts, hence relieving the pain
- Massage to get rid of engorged breasts
Breast massage improves blood and lymph circulation, hence reducing congestion and obstruction. Massage the breast using organic oils such as coconut or olive.
Massage also helps reduce breast tightness and relieves pain.
- Pain relieving medications
Take a painkiller such as ibuprofen to help alleviate pain from the swelling and make it comfortable for you to breastfeed. Always remember to ask for your doctor’s advice before you buy any over the counter medication
- Regular breastfeeding
If your baby sleeps a lot, wake up the baby for feeds more often, you should also breastfeed as long as possible. Change positions to help drain all areas of your breasts
Natural treatments are widely known to help alleviate symptoms of engorgement. These readily available remedies are effective when used correctly, patience is the key, but you will eventually see the results.
Engaging in exercises that tighten and targets breast muscles will help reduce breast enlargement. The best exercises for this purpose include chest presses, chest compressions, and wall push-ups. These exercises involve movement of arms to help tone the muscles of the arm and that of the breast tissues.
You should not do extraneous exercises at the start, do these exercises daily for about an hour and get a rest. It is advisable that you get a professional to help you out on your workouts to ensure that you are doing the exercises correctly.
Comfrey leaves are enriched with muscle relaxant properties and pain relieving compounds to help you relieve breast engorgement symptoms
- Put some water to boil
- Take comfrey leaves and put them in a sieve
- Hold the sieve with the leaves on the boiling pot
- Let the steam hit the leaves for a while until moist
- Wrap the moistened leaves into a thin cloth
- Place the leaves on the breasts and wear a tight holding bra
- Allow the leaves to stay in place for 30 minutes and repeat the procedure as much as you can in the day.
- You are likely to notice results within the next two days
Ice pack relief
Cold compressions go a long way in relieving breast engorgement. Cold packs reduce breast tightness. It is advisable to use refrigerated cold cloth compared to cold cubes
- Take two pieces of clean towels and dip in water
- Place in the refrigerator for about half an hour
- Remove the towels from the refrigerator and fold to fit in a bra.
- Wear a firm bra after placing the towels on the breast tissue
- The towel holds coldness for longer and spreads it uniformly over the entire breast.
- Repeat this 3-4 times daily to reduce breast tightness.
Cabbage leaves are one of the most practiced home remedies for breast engorgement relief. Relief is almost instant, but it is advisable that you repeat the process below until the swelling and hardening goes away.
- Take two cabbage leaves and cut them into your breast size
- Place them over your breast and create nipples for them to stay out of the leaves
- Place the shaped leaves into the refrigerator for about an hour
- Cover your breasts with the cabbage leaves after breaking their veins over a cylindrical object
- For best results apply twice daily
A warm towel stimulates the breast tissue blood, by relaxing the surrounding muscles.
- Take a clean towel and dip it in water
- Squeeze the excess water out and cover your bosom with it
- Do this every time before breastfeeding, to relieve you of pain and breast tightness.
This procedure helps milk flow out continuously, and also makes the nipple soft for the baby to suckle. Alternatively, you can also take a warm bath and let the water flow over your breasts.
If not prevented or properly treated, engorged boos could highly affect the mother as well as the baby, as stated below:
- Poor latch
If your breasts are overfull and hard, the nipples tend to become flat. Flat nipples and a hard breast make it tough for your baby to latch on.
- Inadequate breast milk supply
If the swelling is not relieved, and your baby is unable to breastfeed, your breast milk will not be expelled. When breast milk is not expressed on time, stimulation of more breast milk production fails to occur. This could put your milk supply at risk.
- Underweight baby
If your child is having trouble latching onto your breast, he may not be able to get enough or required amount of feeds to help them grow and develop well. A baby whose weight is less than it should is at risk for contracting several illnesses as a result of low immunity.
- Forceful flow of milk
The pressure from the backup of milk in your breasts can lead to an overactive let-down reflex and a very fast flow of breast milk out of your breasts. A hyperactive let-down or a fast flow of milk can cause your baby to gag, choke, and swallow excessive amounts of air as he’s trying to gulp down the breast milk.
- Breast refusal
Your baby may become frustrated from a painful latch, not getting enough breast milk or a swift flow. These engorgement related problems can result in refusal to breastfeed.
- Breast problems
Breast engorgement can lead to other breast issues including sore nipple blebs, plugged milk ducts, and mastitis.
- Early Weaning
Sore, swollen breasts often begin at home after discharge from the hospital. Since it can be painful and cause difficulty with latching on and breastfeeding, it’s a common cause of early weaning.
If you wean your baby early, you deny them the best nutrients that come with breast milk.
Not all post-delivery women experience engorged breasts. For those who do, it might be hectic to deal with a newborn and engorgement at the same time.
Here are tips on how you can prevent your breasts from being engorged:
- Breastfeed within two hours after birth if possible.
- Nurse between 8 and 12 times a day after the first 24 hours. Look for your baby’s hunger. Wake your baby if more than three hours go by from the start of one feeding session to the beginning of the next.
- Let your baby finish nursing on one breast before switching to other. This will typically take between ten 5 to 10 minute. Your baby may not nurse on the other side. If she doesn’t, just start on that breast next time.
- Do not introduce bottle feeding to your baby in the first month unless your doctor advises you to. You should train your baby’s mouth muscles to suck properly to avoid them failing to do so adequately in the future.
- Always pump out breast milk, in a case where you are advised to feed your baby using milk formulas.
- If a feeding is skipped or your baby doesn’t nurse well, hand express or use a breast pump to get the milk out.
When to see the doctor
You should seek immediate medical attention when you notice the following:
- Body aches and chills
- Pain and swelling in one or both breasts
- Tender breast lump that increases in size each day
- A small white or greyish bump on the nipple
- Discharge from the nipple.
- Increase in redness of the breast tissue
SOURCES AND REFERENCES
- Breastfeeding problems after breastfeeding (March 2013): http://www.webmd.com/parenting/baby/after-nursing#1
- What is breast cancer? (September 2014): https://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm