For the first few days after giving birth, a new mother’s breasts remain soft. They will produce colostrum. Colostrum, the first milk, is available in just the right amount, and is rich in immune factors that protect newborns. Sometime during the next few days, the breasts will become full, firm, warm, and perhaps tender. Once your milk has come in engorgement may occur. Engorgement is normal, and lasts for various periods of time depending on the individual woman. Some women experience only a day or so of mild, easy-to-manage engorgement. For other women, engorgement may be more intense, and can last from several days to weeks.
Some women seem to bring in a larger early milk supply. Others seem to experience more breast swelling. For these women and their babies, the engorgement period may seem more difficult. The breasts will adjust over time, eventually making exactly the right amount of milk for the baby.
It is the baby’s job to help the mother through engorgement by removing milk. If the baby is not latching properly or feeding frequently enough (or if your baby is not latching yet), the breasts may become overly full. This reduces the elasticity of the breasts and nipples. When the breasts are too firm, some babies cannot grasp enough tissue to latch on well. They may suck overly hard trying to pull in the breast tissue. This can lead to sore nipples. If poor latch results in poor emptying of the milk, the build-up can cause breast engorgement to become severe. The breasts may redden and become painful. Mothers may sometime develop a low-grade fever. (Fever may also signal infection, so at the first sign, call the doctor.)
Along with making mothers feel ill, severe engorgement may interfere with milk production. The milk pooling in engorged breasts releases chemical signals that tell the body to decrease milk production. If unrelieved, prolonged engorgement can contribute to insufficient milk supply or begin the weaning process.
- Begin breastfeeding as soon as possible after the birth, to give the baby time to learn to breastfeed before the breasts become full and firm.
- Unless medically indicated, avoid early use of bottles and pacifiers while the baby is learning to breastfeed.
- Once the milk comes in, breastfeed at least 8 times in 24 hours to prevent over-fullness.
- Ask for help from the hospital lactation consultant so that latch-on problems are solved as soon as possible.
- Any time a feeding is missed, use hand expression or a breast pump to remove the milk.
- Always wean gradually.