Yikes, it hurts and it is very common after delivery whether you choose to breast feed or not. Engorgement is one of those un-pleasantries of childbirth that few people talk about and it can make you feel more like a dairy cow than a mother. Learning how to deal with engorgement and knowing the nitty-gritty details can help ease your pain and your fears about the state of your breasts.
Many women begin to fill up with colostrum or leak milk prior to delivery. In fact, about 3 out of every 5 women have enough milk in their breasts during pregnancy to be able to manually expel it at any time. As the nipples change and delivery becomes closer, the breasts fill with extra tissues, lymphatic fluid as well as colustrum and milk. As the hormones plummet and transition after labor, your body will begin producing more milk which will cause your breasts to become engorged very quickly. Each women handles engorgement differently and the symptom can vary slightly.
When your milk drops, typically 2-3 days after delivery your breasts can feel very warm to the touch and hard as rocks. In fact, they become so sensitive that wearing a bra, lying on your stomach of having them even lightly bumped into can make you feel like crying. The relief can come from breastfeeding; however, it too can be short lived. As your baby begins suckling even more milk may come in and many women feel as though they are drowning their baby in a sea of breast milk. The best thing to do is to allow the milk to expel on its own if possible and then offer the breast to your baby. This way they will not be trying to gulp down mouthfuls of milk gagging and sputtering with every swallow. If your milk supply is excessive, you can also hand expel or pump milk when you begin to feel engorged.
For women that are not breastfeeding, engorgement can be a double-edged sword. While many doctors will recommend that you pump to expel the fluid, this will only heighten your milk supply. The problem is that a water balloon filled to capacity HAS to burst and that is exactly how your breasts will feel. Rocking or hearing your baby cry will cause what is referred to as let down, which is when more milk drops from the mammary glands into the breasts. For bottle feeding moms, it is best to handle engorgement as best as possible. Typically, it takes a week to ten days for your milk to lessen and eventually dry up. You can pump or hand express milk when the pressure becomes too much however allowing it to flow out naturally may be the best way if you are not planning to breastfeed.
For the mothers that breastfeed, breast engorgement will eventually slink back into one of your memory files as you begin a schedule of supply and demand. By the second or third month, you will notice that your milk lets down or drops in, at or around feeding time or as your baby begins to suckle.
Probably one of the worst side effects to engorgement, besides the pain is the leakage that often occurs within the first few weeks of delivery. During the night, your breasts will leak and you may find that you are washing sheets and changing clothes more for yourself than for your baby. Using nursing pads can help however, you may be better off to place bed pads underneath you while you sleep. Sexual stimulation can also cause a let down of milk which can be uncomfortable. The problem with this leakage, whether on your bed or on your clothes is that since it is a milk derivative, it eventually sours and makes you feel genuinely icky. As the engorgement begins to lessen, this too will pass. In the meantime, use nursing pads and try to wear under shirts that fit snuggly to prevent leaking and engorgement.
Engorgement can also be a sign of trouble and lead to infection. While it is normal for your breasts to feel warm to the touch, if they become hot or itchy or the milk that is expressed has blood or pus in it, you may be getting a breast infection. One of the best ways to deal with the pain is to massage the breasts with lotion, starting at your underarms and working your way down to the nipples. If you feel lumps or bumps, try to massage them with enough pressure to loosen the milk so that it doesn’t get hard and cause further pain. You can also soak your breasts in the bathtub or shower and massage them while you are in there to help ease the pain.
Another solution to breast engorgement can be evening primrose oil. If you are not breastfeeding, you may want to consider taking this supplement which is helpful in breast care as well as other aspects of female care after delivery.
Years ago, many women took medications that would help milk dry up and lessen engorgement. These medications are no longer safe and have been linked to serious disorders. Wearing tight wraps around the breast may help, however you have to give your breasts occasion to breathe. For many women, once they become engorged going without a bra can be extremely painful. Taking doses of Advil or Motrin can be effective because they have anti-inflammatory properties. Some women, (not breastfeeding) also get relief from taking over the counter fluid pills which help to alleviate some of the lymphatic fluids that can build up in the breasts.
Engorgement is normally short lived. While you are experiencing it, it can be very painful and disruptive to your normal life. It can make you feel better to know that it is normally very short lived, and rarely turns into a problem for breastfeeding or bottle-feeding moms. If you have concerns consult your OBGYN or lactation consultant.