Breastfeeding - Management of Common Breastfeeding Issues

Engorgement

Some breastfeeding mothers suffer from engorgement in the early postpartum days. It results from the increased blood supply, swelling of the breast tissue, and the milk contained in the breast. The discomfort can be mild to severe. If engorgement is not relieved, the infant will have difficulty latching on and extracting the milk, which may lead to a diminished milk supply. Frequent and complete feeding (every 2-3 hours for at least 10 minutes per breast) can prevent or minimize engorgement in many mothers. If your infant is unable to latch on and nurse effectively, you will need to pump or manually express your milk to establish a flow and maintain a good supply. The following is the "spa treatment" for engorgement. This treatment plan should be used every 2-3 hours around the clock until the engorgement is resolved.

• The "Warm-Up"
  Prior to feeding or pumping your milk, apply a warm, moist compress to both breasts. This will help with milk flow. To make a warm compress, roll or fold a wet but wrung hand towel in a dry hand towel. Place both towels in the microwave and "cook" for 2 minutes. The towels will be very hot to touch. When you can comfortably handle the towels, wrap the wet towel completely around both breasts and cover with the dry towel. Leave in place until the towels have cooled (usually about 2-3 minutes).
• The "Exercise"
  Begin pumping or allow your baby to latch on and nurse immediately after you have removed the towels. You should pump with a good electric pump for at least 10 minutes or longer if your milk flow is still strong. Manual expression is less effective and will take longer. If your baby is latched on, allow him to nurse at least 10 minutes on each side.
• The "Cool Down"
  After you have pumped or nursed your baby, apply a cold compress to both breasts. This will reduce swelling and minimize the pain associated with engorgement. Chilled gel packs work well and are more convenient and comfortable than ice packs. As reported by generations of breastfeeding mothers, cold cabbage leaves placed on the breasts also work. (Yes - they really do!)