Yikes! Engorgement can hurt, and it is a very common experience after delivery, whether you choose to breastfeed or not. Engorgement is one of those unpleasant aspects of childbirth that few people discuss, making you feel more like a dairy cow than a mother. Learning how to deal with engorgement and understanding the details can help ease your pain and alleviate 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 three out of every five women have enough milk in their breasts during pregnancy to manually express it at any time. As the nipples change and delivery approaches, the breasts fill with extra tissues, lymphatic fluid, as well as colostrum and milk. When hormone levels drop after labor, your body starts producing more milk, leading to rapid engorgement. Each woman handles engorgement differently, and symptoms can vary slightly.
Typically, when your milk comes in—usually 2-3 days after delivery—your breasts can feel very warm to the touch and as hard as rocks. They become so sensitive that wearing a bra, lying on your stomach, or even having them lightly bumped can bring you to tears. Relief can come from breastfeeding; however, this relief may be short-lived. As your baby suckles, even more milk may flow in, and many women feel as though they are drowning their baby in a sea of breast milk. The best approach is to allow the milk to expel on its own, if possible, before offering the breast to your baby. This way, they won’t be gulping down mouthfuls of milk and gagging with each swallow. If your milk supply is excessive, you can also hand-express or pump when you begin to feel engorged.
For women who are not breastfeeding, engorgement can be a double-edged sword. Many doctors will recommend that you pump to relieve pressure, but this may only increase your milk supply. The problem is that a water balloon filled to capacity has to burst, and that’s exactly how your breasts will feel. Rocking your baby or hearing them cry can trigger a letdown, causing more milk to flow from the mammary glands. For bottle-feeding moms, managing engorgement as best as possible is crucial. Typically, it takes about a week to ten days for milk production to decrease 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 option if you’re not planning to breastfeed.
For mothers who breastfeed, engorgement will eventually become a distant memory as you establish a schedule based on supply and demand. By the second or third month, you’ll notice that your milk lets down around feeding time or as your baby begins to suckle.
One of the most frustrating side effects of engorgement, besides the pain, is the leakage that often occurs in the first few weeks after delivery. At night, your breasts may leak, and you might find yourself washing sheets and changing clothes more often than your baby does. Using nursing pads can help; however, placing bed pads underneath you while you sleep may be even more effective. Sexual stimulation can also cause milk letdown, which can be uncomfortable. Unfortunately, leakage—whether on your bed or clothes—can sour and make you feel genuinely icky. As engorgement begins to lessen, this too will pass. In the meantime, use nursing pads and consider wearing snug-fitting undershirts to help prevent leaks and engorgement.
Engorgement can also signal trouble and lead to infection. While it is normal for your breasts to feel warm, if they become hot, itchy, or if the expressed milk contains blood or pus, you may be experiencing a breast infection. One effective way to deal with the pain is to massage your breasts with lotion, starting at your underarms and working down to the nipples. If you feel lumps or bumps, apply enough pressure to help loosen the milk, preventing it from hardening and causing further pain. You can also soak your breasts in the bathtub or shower while massaging them to help ease discomfort.
Another solution for breast engorgement is evening primrose oil. If you are not breastfeeding, consider taking this supplement, which is beneficial for breast care as well as other aspects of postpartum recovery.
Years ago, many women took medications to help dry up milk and lessen engorgement, but these medications are no longer considered safe due to links to serious disorders. Wearing tight wraps around the breasts may provide some relief, but it’s important to allow your breasts to breathe. For many women, going without a bra can be extremely painful once engorgement occurs. Taking doses of Advil or Motrin can be effective because they possess anti-inflammatory properties. Some women who are not breastfeeding find relief from over-the-counter diuretics, which help reduce lymphatic fluid buildup in the breasts.
Engorgement is usually short-lived. While it can be very painful and disruptive to your daily life, it’s comforting to know that it rarely becomes a long-term issue for breastfeeding or bottle-feeding moms. If you have concerns, consult your OBGYN or lactation consultant.