Breast Engorgement: Causes, Steps to Reduce it, Prevention

Breast engorgement seems to be an issue a lot of mothers come to experience once they start lactating. It is a normal yet uncomfortable occurrence that can spur anxiety and sabotage your routine for your baby. In this post, we would like to talk about the causes of breast engorgement and how to resolve the problem so that you can make the breastfeeding journey easier.

Causes of Engorgement in Breast Tissue

Breast engorgement is a sophisticated way of saying that the breasts are overfilled with milk supply. It can affect one or both breasts. The number one reason it happens is that breasts aren't emptied as often as necessary. 

As a result of this, the milk supply accumulates in the lobules until there is hardly any room left, causing sore nipples, as well as hard, swollen and painful breasts. Sometimes the pain could radiate to the armpits.

Breast engorgement is more likely to materialise on the first days after your baby is born but is not uncommon at any other point during the lactating period. The body directs blood flow and other fluids to the breasts to boost milk production, which sometimes causes congestion.

Occasionally, swelling may occur because the body has not yet adjusted to the baby's needs and is trying to figure out how much milk to make. Moreover, the increased blood flow in the area only adds to the current pain you're encountering. When a baby is feeding off the breast, its saliva sends data to the mother about the amount of breast milk that has to be produced. This way, the adjustments to the milk production can be made to meet the offspring's changing needs, especially during those growth spurts.

However, sometimes, the body may just make more breast milk than required, especially if the baby misses a feed.

In addition, some mothers experience breast engorgement as a result of the administration of IV fluids during delivery. (It happens because of dehydration.) This might put a spoke in the wheel of the lymphatic system, giving it a hard time to do its job efficiently.

Last but not least, you may develop breast engorgement if you cease breastfeeding all of a sudden.

Now, it is worth mentioning that in some women, engorgement may be accompanied by fatigue and low-grade fever, known as a "milk fever". This is completely normal and should not stop you from breastfeeding.

What to Do When Your Breast is Engorged? How to Reduce Breast Engorgement

If your goal is to deal with the pressure that comes with breast engorgement, the last thing you want to do is use a pump. Yes, it may help with the problem in the short term, but it won't be too long before you notice exacerbation of the symptoms. But let's review the options:

• Use a warm compression with cautiousness. This will soften the tissues and enable breast milk to come out easily. It is important to keep the compress on for no more than 5 minutes, or it will have the opposite effect. Applying too much heat to an area for too long could worsen swelling and lead to inflammation. Some people advise opting for the use of a warm sleeve, but science has shown that it doesn't work as effectively and that sometimes it can do more harm than good. Alternatively, you may take a warm shower prior to feeding your baby (but do not let the shower spray directly onto the breast surface). It will ease milk flow.
• Go for cold compresses. If you don't feel okay with the first option, lay a cold compress or ice pack over the engorged breasts to ease discomfort and minimise breast swelling. Do this in between feedings. The truth is, there are different opinions about these strategies, so you might want to go with your gut or just try both options and see which one works better.
• Feed your baby often. It is always best to breastfeed instead of pumping because pumping may signal your body that it has to produce more milk than your baby actually needs. With breastfeeding, the messages your body is getting from your baby will carry information about the amount of milk that's needed. And if it has been making too much milk, it will slow down a bit.
• Try a breastfeeding med. An OTC painkiller will relieve pain associated with breast engorgement and fast at that. If you don't feel like taking medication while still lactating, consult your doctor.
• Express milk / Stick with a manual breast pump to get a little milk out at a time. This will work better than an electric pump because it will allow you to have more control over how much milk you let out. It is recommended to go with reverse pressure softening or to hand-express breast milk because it is gentler, so to say. Despite that, you should use it as a last resort because it may fool your body into thinking you need more milk. It's tricky. And you have to see for yourself whether it can be beneficial or not.
• Gently massage your engorged breasts. When your breasts are swollen, gentle massaging can help deal with the problem and improve milk flow. Go around in circles and don't apply much pressure. Use the pads of your fingertips and work your way around the nipples. Additionally, try pushing them back into your chest wall.
• Feed from one breast. If you are dealing with excess milk (oversupply), try feeding your baby from one breast at each nursing session; then use the other breast for the next breastfeeding.

Please note that the things you do or don't can make engorgement worse, which in turn may result in blocked milk ducts, making it impossible for the baby to latch on. And sometimes, it will trigger a breast infection known as mastitis. This is something that does not resolve on its own. You need to be put on antibiotic treatment. So, while you don't want to be overly concerned about breast engorgement, you also don't want to downplay the risks.

How to Ease Breast Engorgement Pain

In the previous paragraphs, it was already made evident that breast engorgement pain can be managed with a cold pack/cold compress, OTC painkillers, and hand-expressing to let out the milk that has accumulated in the breast tissue and is causing the discomfort. If these methods don't prove efficient, you should definitely have a word with a health care provider since something else may be going on.

How to Prevent Breast Engorgement

So, you know how to relieve breast engorgement once it happens, but the best-case scenario is never to develop it. How do you do that? Well, first of all, you need to be aware that if you do get the issue the first few days after delivery, it is because the body is trying to determine how much milk to produce. There is nothing you can do about that except wait and give it the time it needs to accommodate. The pain and swelling will go away on their own.

However, to prevent breast engorgement from happening over and over for as long as the nursing phase lasts, follow these tricks:

• Breastfeed regularly so that milk and excess fluid don't collect in your breasts, causing engorgement. If you don't breastfeed, make sure to pump as often as necessary to avoid the problem (but don't go overboard).
• Wean your baby gradually from breastfeeding. If you stop too abruptly, it will take a while for breast milk production to catch up.
• Do not pump too much either. Aggressive pumping often has the opposite effect. Go with small amounts to relieve symptoms.
• Apply ice packs to your breasts to decrease milk supply and alleviate inflammation until your body adjusts to the new experience.
• Wear a supportive bra. This will minimise the chance of engorgement.

Remember that you should discuss all of these things with a child health nurse or another healthcare provider. They will address any concerns you have and guide you into the process so that you and your baby are feeling fine. Besides the above, you should also expect to get trustworthy health information from them.

Can Breast Engorgement Cause Shortness of Breath?

When you experience breast engorgement, you get chest heaviness, which may make it difficult to breathe for a while, but it is not likely to result in severe shortness of breath. If the problem is unrelated to breast engorgement, it can exacerbate quickly. Your best bet would be to see a doctor about it and rule out any serious conditions that may need urgent care.

Final Thoughts on Engorged Breasts and Breast Milk Supply

Breast engorgement may be unpleasant and annoying, but you can implement various strategies to reduce swelling and restore normal breast fullness. If you are new to this and don't know what to do, don't hesitate to turn to a lactation consultant and get those worries off your chest.

They will tell you how to figure out if your baby is getting enough milk and whether it is developing normally. You will also get worthwhile tips about milk production and feeding your baby.

One thing is for sure, you would want to do something about the problem as soon as it occurs, not only for the sake of pain relief but also because severe engorgement can lead to mastitis and blocked ducts if you don't act on in time.