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Breastfeeding: What To Do in Case of Breast Engorgement?

Breastfeeding: What To Do in Case of Breast Engorgement?

Breastfeeding, however important, can unfortunately be interrupted by problems that seem unsolvable. Among these, one that most commonly obstructs breastfeeding is mammary engorgement. Before understanding how we need to intervene, we try to know its causes, in order to prevent its onset. It can happen especially during the first weeks of breastfeeding, when the so-called calibration phase takes place. Phase in which milk production changes to adapt to the child’s requests. These requests change fairly quickly in the early stages of his life, considering the rapid pace of growth, it is understandable that this happens.



Breast congestion

When there is an imbalance between the production of breast milk and the quantity of milk that is fed from the newborn it is possible to incur some discomfort. These are frequently responsible for the early termination of breastfeeding. Breast engorgement is a drawback that generally tends to occur as a result of the increase in size and pressure at the level of the mammary gland. This increase is secondary to a series of mechanisms for the production and accumulation of breast milk awaiting feeding. The traffic jam tends to manifest itself when one passes from the synthesis of colostrum to that of mature milk. This phase therefore coincides, generally, with the milk line. But it is not necessarily said that we should necessarily expect to fall into such disorders.


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Traffic congestion

At 2-4 days after birth, the real milk appears, depending on whether there has been an early attachment or not (in the second case it is possible that delays of a few days). In this phase, breast milk is produced in abundance, and with a composition decidedly different from that of colostrum. This change takes place to best meet the nutritional needs of the ever-changing baby. Sometimes the quantity of milk produced, at the arrival of the milky whip, dramatically exceeds that necessary for the newborn to satiate. The remaining milk, if it is present in important quantities, can stagnate in the milk cisterns, responsible for its collection while waiting for the feed, and cause discomfort.



The milk stasis may be due to many conditions. For example: wrong handling of feedings, unjustified use of the addition of artificial milk, the lack of use of the breast pump or the manual squeezing of the breast when necessary. How to guarantee the correct emptying of the mammary glands and at the same time respecting the baby’s time? The best thing is to let the child teach his mother how many feeds he wants per day and how much milk he should receive in each of them. Every child has their own needs to grow, and their own time to feed themselves better and feel safe and secure. Breastfeeding, in fact, is also a moment of pampering between mother and child, and the best thing to do is to respect breastfeeding on demand.


breast engorgement
breast engorgement

Sore breast

Breast engorgement can occur even after the milk supply. For example, when you switch from one to the other on a fixed-time basis, or if for some reason you switch from very frequent feedings to less frequent feedings. Other causes may coincide with the use of very tight bras, underwire or the presence of a breast prosthesis. Skipping a few feeds results in insufficient suction and therefore the elimination of a small amount of milk. To this real physical block of the passage of milk follows a quite recognizable symptomatology. The breast appears swollen, reddened, warm, painful to the touch and also quite hard. The engorgement can be further aggravated by insufficient breastfeeding or by any cause of blockage of the galactophores. For this reason we must not panic and abandon breastfeeding.



Bad breast

Breast tension causes a variable pain depending on the degree of obstruction. In more advanced cases, the skin of the breast may appear taut, edematous and shiny, slightly nodular and sometimes it is evidently red. Those who do not know the manifestation often believe that a lump has appeared in a breast area. In the aforementioned area the skin appears, however, more reddened and warm. In addition, breast engorgement is often associated with vascular and lymphatic congestion. The condition can cause edema and redness of the nipples. In cases where the breasts appear very taut and swollen, the nipple can be slightly retracted inside the areola. This condition could make newborn attachment and suction much more difficult. In this way, it is easy to fall into the vicious circle in which the insufficient suction further aggravates the engorgement of breast milk. This inevitably leads to an increase in milk stagnation in the mammary gland.


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Breast pain

Very often, in addition to breast pain, the woman feels a sense of malaise, loss of appetite, fatigue, weakness and chills. The traffic jam involves general discomfort and a consequent discomfort in breastfeeding. A slight feverish rise can be observed and, if neglected, the engorgement can also lead to mastitis. The latter is an inflammation of the mammary gland, which often arises from the obstruction of the galactophores. From the mastitis one could even have, if not adequately treated, the appearance of an infection with an aggravating symptomatology and a circumscribed abscess. In this case, the slight feverish rise evolves into a considerable increase in temperature.



Feeding time

It is absolutely understandable that in the presence of such symptoms one wonders whether it is appropriate to continue breastfeeding; but adequate information can prevent mother and child from renouncing an important source of well-being and health for both. It is very important to continue with regular breastfeeding. For this reason, after recognizing the traffic congestion from the symptoms, it must be activated as soon as possible. The earlier the resolutive action is, the sooner a normal breastfeeding will resume.



Remedy breast engorgement

When it is not possible to attach the baby to the breast, it is advisable to resort to manual squeezing or to the breast pump. In this way it will be possible to stimulate the breast and keep the breast milk, according to measures designed to keep its properties intact. Manual squeezing of the breast is a very useful practice in case of traffic jam. It proceeds with delicate circular massages to move, following a hot bath or a hot-humid compress, the congestion of milk. To then “squeeze” just as gently the dusts galattofori that convey the milk to the areola.



Breast congestion remedies

How to breastfeed if suckling does not match the milk spill and breast pain increases? The best approach is to put into practice some natural remedies that facilitate milk leakage. The best way to dissolve breast engorgement, without causing further pain, is the use of “hot-wet compresses” followed by a gentle local massage. The application of these packs should be carried out for about 10 minutes before feeding. Just wet a towel and fill a hot water bottle. Then place the towel over the breast with the hot water on the bag.



Breast jam what to do

The heat of the pack, which gently wraps around the breasts, favors the breakup of the traffic jam and the slow and delicate release of the affected galactophore duct. In this way, the milk automatically starts to drain as soon as the duct-galactophore has been released. It will be possible to stimulate this procedure by applying a gentle massage with two fingers in a circular direction in correspondence with the galactophores. Furthermore, it is possible to observe the resolution of the jam due to the leakage of a few drops of milk, after exerting a slight pressure under the areola. After receiving this “test” you can attach the child to the breast without problems. Take care to correctly attach the baby to the breast to avoid further discomfort.




During the feeding, it helps to relax and allow yourself a moment of tranquility. This is why it is important to find a comfortable position that allows mom and child to enjoy this magical short period of intimacy. Comfort is also important in clothing, in this circumstance, for example, a bra with wide straps that do not scratch, with open cups, able to comfortably hold the breast, can help to alleviate the discomfort and painful symptoms. At the end of feeding, in certain circumstances it is advisable to apply cold compresses to reduce the swelling of the breast, but it is not always necessary. Some therapeutic options used in the past (compressive bandages, cabbage leaves, limitation of fluid intake) have now fallen into disuse. Furthermore, there is no longer any recourse to bromocriptine, used in the past in order to inhibit milk production.




Breastfeeding the baby often, after having made sure to melt the congestion through hot-humid compresses, is the best way to restore the normal flow of milk. The production, accumulation and ejection of the same will begin to follow the regular cyclical path, adapted to the needs of the child. If the child has difficulty sucking, before feeding it is good to remember to gently massage the breast and let out a few drops of milk, in order to facilitate the attack. For those who can not solve the problem alone, you can contact a midwife. Professional help will allow the mother to understand the right method and to correct herself with awareness, without having to abandon the possibility of breastfeeding her child.

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