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During the first few weeks
after delivery as the colostrum "starter milk" is
changing to mature milk, your breasts will become full. This
normal postpartum fullness usually diminishes within 3-5 days.
Engorgement can occur if your baby does not adequately remove
milk from your breasts. This causes your breasts to feel hard,
painful and hot. This is due in part to extra blood and
swollen lymph nodes, not entirely to accumulated milk.
Excessive fullness of the breasts can also lead to swollen
areolas (the dark area around the nipple) and flattened
nipples, making it difficult for the baby to latch-on,
You can prevent engorgement by following these simple
guidelines: Breastfeed your baby frequently, 8-12 times in 24
hours. Unless it's recommended by your health care provider,
avoid supplements of water or formula for the first 3-4 weeks.
If you miss any feedings, express (pump) your milk, and when
weaning your baby, do so gradually.
Engorged breasts can be treated in several ways. Try applying
hot, moist towels to your breasts for a few minutes, or taking
a hot shower before nursing your baby. After using moist heat,
hand-expression of milk will help soften the areola, making it
easier for the baby to latch-on to your breast. You may also
want to use gentle massage, deep breathing, soft music or
other relaxation techniques before and during nursing. Icy
cold compresses applied to your breasts can relieve discomfort
and swelling after breastfeeding.
If your baby takes only one breast, you can alleviate
engorgement of the breast that is not nursing by using a
breastpump or by hand expressing milk. If your baby can't
latch-on or your nipples are flattened, use a hospital-type
electric breastpump or hand expression to soften the areola.
Use moist heat and breast massage before pumping. Continue
pumping every two hours, 10 minutes per breast, until your
baby can latch-on.
If your nipples remain flat, wear multiple-holed breast
shells for half an hour before breastfeeding. This will
help draw out your nipple, making it easier for the baby to
Avoid bottles, pacifiers and nipple shields. These may cause
Wearing a proper-fitting, supporting nursing
bra will make full breasts more comfortable and prevent
the discomfort of engorgement.
If you have further problems, contact your health care
professional or breastfeeding specialist.