In another article, we explained the coming in of mature milk after colostrum: this is a physiological process and takes place 24-48 hours after birth. But this process can come with complications and become a painful problem. Today, we will talk about breast engorgement and how to solve it.

But let’s start from the beginning: What is breast engorgement?

Engorgement is an accumulation of liquids: liquid, blood, and plasma in your breast in the first days after birth. The blocked liquid forms a swelling and prevents the exit of milk through the nipple. This causes pain and inflammation and makes it impossible for the baby to breastfeed.

Why does engorgement happen?

Engorgements are more frequent in mothers who have had long births and have received lots of intravenous fluids. Also, mothers who have had a complicated onset of breastfeeding or have been separated from their babies for many hours may suffer from this annoying complication.

It should be said that engorgement is a serious medical problem and is very different from the feeling of fullness mothers experience during the normal coming in of (mature) milk at the beginning of breastfeeding a new baby. This feeling of fullness is absolutely normal when breastfeeding begins, but it should never be painful or even prevent the baby from breastfeeding.

My baby can’t latch onto my breast or seems to reject it. Why?

When the breast is seriously engorged, it will be so hard and solid that it is impossible for the baby to position her tongue correctly and obtain a proper milk transfer. For a baby, this will be almost like feeding from a wall! Sometimes, the baby manages to latch on but does not feed with the correct suction motion because it cannot make the right tongue movement to express the milk. They might spend a while attached to the breast, and when they let go, the breast feels just as hard as before.

Other babies get angry and cry when they can’t breastfeed, and you might think that your baby is rejecting your breast.

What NOT to do in case of engorgement

Sometimes, you might do things that make engorgement worse, and without knowing it, you make it even harder to solve the problem. The most important are:

• Apply heat: as said before, engorgement is an inflammation, and it is not advisable to apply heat because you can make it worse.
• Mother-baby separation: since separation is one of the possible causes of the problem, whenever possible, you should make sure that mother and baby are physically close, ideally skin to skin.
• Postpone feeds: it is possible that you feel the fullness of the breast, but maybe your hospital room (or your house) is full of people, and you feel uncomfortable feeding. But it is not advisable to space out feeds; it would be best if you can offer your baby the breast very often, even after less than an hour has passed between feeds.
• Giving a dummy, pacifier, or teats: this is related to the previous point; studies have shown that the use of dummies/pacifiers or teats can interfere with a good latch of the baby to your breast. So, in the first days (or weeks) after birth, they are best not offered to the baby in order to establish breastfeeding.

How can I remove breast engorgement?

Removing the engorgement allows you to alleviate the pain and helps the baby to feed. First of all, you need to unblock the milk flow. In order to do this, you must avoid applying heat to the breast, and you need to apply cold with things like cabbage leaves, clay, cold ice packs, or simply frozen vegetables (wrapped in a towel).

Then, to drain the milk, it is necessary to apply the so-called Reverse pressure softening (RPS) massage that allows the areola and nipple to soften so the baby can latch on properly.

Once the baby has finished feeding, it is necessary to apply cold again. If your doctor has prescribed anti-inflammatory drugs, you can continue to take them until your breasts get better. The anti-inflammatory drugs given after birth should be safe when breastfeeding a baby, but you can also check if you can take them at www.e-lactancia.org.

How long can engorgement last?

Following all the above recommendations, it should be cleared in 24 to 48 hours. Your breast will improve if you follow all the above measures, and the engorgement will eventually disappear completely.

Do you have any more questions?

You can find more information about all things breastfeeding in our free app, LactApp, for iPhone or Android. In the contact section of the app, you can find an in-app consultation channel where our experts will answer your questions.