How to Recognize and Treat Engorged Breasts

A few days after you give birth, your milk will start coming in. Prior to this, your breasts have just been providing your infant with colostrum, which is a milky substance that contains important antibodies necessary for your baby's first few days of life. When your milk comes in, though, your breasts will feel full, tender, and maybe even a little lumpy (this alarmed my husband at first when it happened to me until I explained to him what was going on). You may also notice a slight fever and a throbbing or shooting pain that can extend all the way to your armpit.

When your milk first comes in, your body doesn't really know yet what kind of milk supply it will need to produce for your baby. Each baby is different. In the beginning, your body automatically errs on the side of caution and produces what should be more than enough milk. An abundance of blood is sent to your breast tissue, and this causing much of the swelling that is seen in engorged breasts. Each woman's body is different, just as each baby is different. Some women may feel little or no swelling or pain, while others experience full engorgement, complete with full, hard, painful breasts.

One thing you need to do is make sure you are wearing a good, supportive nursing bra that fits well. If you are unsure of what size you need, you may want to see a lactation consultant or go to a special lingerie boutique that does fittings. Chances are your breasts are not the same size they were before you got pregnant, or even the size they were during pregnancy. Lactation causes many changes in your breast tissue.

Try to breastfeed as often as you can. Most pediatricians and lactation specialists recommend feeding every 2-3 hours. If your infant only feeds off of one breast at each feeding (as mine did in the very early days), make sure you keep track of which breast you feed from, so you can feed from the other breast the next time your baby is hungry.

A word of caution: Don't let your baby attach to your breast when your areola is hard. This will hurt, and may cause significant nipple damage that may put an end to your breastfeeding attempts for a little while, and you don't want that. Remember: Your milk supply is dependent on the demand from your baby. If you are not breast feeding, there will be no demand, and your milk supply may dry up. Use a breast pump between feedings to prevent engorgement and to make sure that your areolas do not become too stiff.

You can either rent a breast pump (at my doctor's office, they charge $35 per week, and not all insurance policies cover the cost), or you can buy one. I like the Lansinoh Affinity Double Electric Breast Pump. It works really well for most people, and it's a great price.

Be careful, though, if you decide to pump, that you do so only when you need to soften your areola, or if you are having trouble getting your baby to latch on during a feeding. Again, when it comes to breastfeeding, supply and demand are inextricably linked. If you "demand" too much from your breasts through excessive pumping, your body will think that it needs to produce more milk. This will lead to even more engorgement.

You can relieve the swelling and pain from engorgement by taking ibuprofen (not safe for pregnant women, but okay for breastfeeding women) or by placing cold packs on your breasts after each feeding. If you don't have a cold pack, try putting ice in a sealable plastic baggie. Just make sure you wrap the baggie in a washcloth before you put it on your breasts, or you may give them frostbite!

Even though it hurts, you must not give up. If you continue to breastfeed, the pain of engorgement will go away within a few days. Your milk production will even itself out as long as you either breastfeed or pump regularly. Breastfeeding is hard, but it is so rewarding! It is so much healthier for you and the baby - both physically and emotionally. The bond you make with your baby now by putting it at your breast will be there forever. The pain of breastfeeding will not.