Wednesday, December 21, 2011

Nursing Helps: Engorgement

If you have ever nursed a baby chances are you've dealt with engorgement. Engorgement of the breast is characterized by fluid retention that causes swelling and discomfort in the breast -- which can be quite unpleasant when you think of letting a little person nurse. This generally occurs a few days after a mother has given birth, as her milk comes in, and her body stops making colostrum.

As a woman's body moves from the short phase of making colostrum, into full fledged milk production, the body over produces milk until it is able to regulate to how much the baby generally needs. (aren't our bodies amazing? they've been designed in such a way that they over produce so the baby doesn't go hungry, and then regulates to what that specific baby needs. genius design! i love the human body!!!) Surprisingly the swelling of the breasts is not only the over production of milk, but is actually edema, or water retention in the breast tissue. Much like the swelling in a pregnant woman's legs. This will be exacerbated if the mother had an IV during her birth experience due to the extra fluids in her body.

The pain from engorgement last for varying amounts of time for different women -- it lasted for me for about three days. The pain is only part of the issue, though, engorgement can make breastfeeding difficult in the beginning. The swelling of the breast tissue can make it difficult for a baby to get a "good latch". Following is a list of some ideas on how to relieve your suffering, and also help your baby more comfortably nurse as well. (Note: much of my information has come from the genius book
The Ultimate Breastfeeding Book of Answers, written by Dr. Jack Newman and Terasa Pitman. If I am using information from this wonderful guide, I will cite a page number in the bullet.)

  • Cold Green Cabbage Leaves: I heard about this from a dear college roommate of mine (Thank you Katy Kingsley!) It's simple: take a cold cabbage leaf and place it inside of your bra. I have heard people say that it works better if you finely chop the cabbage. I never did this myself, I thought the cabbage leaf shape was so convenient. After doing some research though, I think it might be beneficial to try chopping and making a compress. Leave the cold cabbage on the breast until it is wilted, and no longer cold. Replace with more cabbage as you need. Although the coldness is VERY relieving, the real magic occurs due to the fact that cabbage, according to this research, contains some substance that opens the capillaries allowing the movement of trapped fluids! I have recently heard a woman caution against the use of the cabbage help, stating that it will reduce your milk supply. In all of my reading I only came across one mention of this idea, and it was in negation. I never had a problem with my milk supply after using cabbage leaves, I only found relief. I highly recommend it. One caution that I found in more than one place was that the cabbage should never be placed over areas where the skin is broken, but around. I never found the reason why, interestingly enough. Do any of you know why this is?
  • Cold Grated Potato. This works amazingly well to relieve the pressure of engorgement, and believe it or not, also has the power to cure mastitis. (I was in the middle of nowhere in Canada over the summer, hours from medical help and contracted mastitis. A dear aunt of mine told me about the magical cold grated potato and grated me one that very hour. I used the cold potato as a compress, again, as with the cabbage, replacing the potato once it was no longer cold. I did this one night, and the fever and aching were gone. I did this treatments on two occasions, and the flaming red lump in my breast was considerably shrunken. It took about five days for the bump and swelling to fully diminish. Thank heavens for the potato!!)
  • Reverse Pressure Softening (this is in The Ultimate Breastfeeding Book of Answers
    pp123-124): I'll just quote the book here, "[Reverse Pressure Softening] is best performed immediately before each attempt to latch, for as many feedings as needed. Steady, gentle pressure inward toward the chest wall is exerted for a full 60 seconds or longer, focusing on the areola where it joins the base of the nipple... If the mother's fingernails are quite short, she can press with the curved fingertips of both hands simultaneously, with the nails nearly touching the sides of the nipple. The goal is to create six-eight small "dimples" or pits on the areola at the base of the nipple... If swelling is extremely firm, and the multiple fingertip method is being used, one or more three minute periods of constant reverse pressure may yield better results." There is an alternate method for this method, using the flats of two fingers. You place the length of one finger above the nipple on the areola, and another below the nipple on the areola -- again applying pressure for about a minute. You will then move your fingers to the side of the nipple, holding pressure for another minute, thus making a box. Again it is suggested that this works best if you alternate, top and bottom/sides, for about three minutes. I had a few questions about the first method, and was able to find a website with some diagrams that help. Performing RPS helps move the built up water back into the breast toward the natural drainage system our body's have in place. Displacing that water also helps allow the baby to get a better latch, which will help reduce the swelling with the proper movement of milk through the ducts. (The website whereon I found the diagrammed article quotes the Jack Newman website; same man who wrote the book I've mentioned here. The man's a genius I tell you! There are some great resources on this website, and Dr. Newman's website as well, such as a full explanation of how the breast works to produce milk. AMAZING!)
  • If you do not have potatoes or cabbage, place a cool wet wash cloth around the breast after feedings. This may help reduce the swelling, and will offer great relief.
  • Dr. Newman (p.122) suggests that, if the mother feels the need, taking something such as ibuprofen is in no way detrimental to the baby. Pain relievers such as ibuprofen also aide in reducing swelling.
  • Nurse as often as possible. (Thanks for this tip, Ariel!) This is very helpful as it allows movement of fluids through the breast, and eases tension. Also, I found the more I nursed the easier it became.
As with all thing related to nursing, time is the key. I hope these suggestions are helpful. It might be uncomfortable for a few days as the swelling increases and then ebbs, don't give up on nursing! You won't regret it!


  1. Thanks Lissa. I'll be glad to have these nursing entries on hand in a couple of months! How does one make a compress out of a shredded potato?

  2. I was wondering the same thing, Merzi! The things that helped me were to nurse as much as possible, and not giving up!

  3. Good question! You take a potato and grate it with a cheese grater, then put it in the fridge until it's cold. (Or you could just use a potato that had previously been in the fridge.) You then put the grated potato on anything that will help keep it in place -- such as some plastic wrap, or a plastic bag. A towel, or some paper towels are also a good idea as there will be a little juice running out of the potato. You then place the grated potato directly on your skin. I found it was easiest if I applied the potato, and then laid down. Also I did multiple applications both nights I used the potato, or until the grated potato was gone -- obviously there isn't enough room to use all the potato at once :)

    Ariel, that is a great point! Nursing as often as possible is a very big help! I think I'll make that another bullet point. Thank you!

  4. For me, engorgement at its worst was when I finished weaning Sammy. Even though I was only feeding him once a day during the last month of weaning, it was very uncomfortable for a couple days after we quit. I was so grateful for cabbage leaves! (I've only ever used them whole, and they've worked great.)