Postpartum (Post-delivery) Breast engorgement

What is Postpartum or post-delivery breast engorgement?

Breast engorgement is a common post-delivery symptom experienced by mothers when their breast tissues overfill with milk. It is often painful and temporary in nature.

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Causes

It primarily results from the imbalance of the milk production, where a mother’s body produces more milk than the baby’s requirement. Usually, milk production is preceded by the nutrient-rich fluid called colostrum’s formation. The breasts swell, tingle and increase in size when the milk production starts. Often, breast engorgement resolves after breastfeeding for a couple of days.

Symptoms

Breast engorgement is common in breastfeeding mothers with the following manifestations:

  • A feeling of fullness in the breasts
  • Pain and swelling of the breasts
  • Soreness and swelling of armpits
  • Hard areola
  • Lumpy to touchy breasts

Diagnosis

No special tests are needed to diagnose this condition. Based on the symptoms alone, it can be diagnosed.

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Treatment

Usually, the milk production is balanced in few days depending on your baby’s needs. Simple measures at home can help in relieving its symptoms:

  • Use heat, massage or pumping of both the breasts before you breastfeed.
  • If your baby doesn’t breastfeed, express the milk and store it in the refrigerator for later use (use within 72 hrs).
  • To reduce the discomfort, use a cold compress.
  • When not breastfeeding, avoid warming or stimulating your breasts and wear a supportive bra.

If the pain is not manageable, your doctor will prescribe pain-killers and anti-inflammatory medication.

Prevention

You can prevent breast engorgement by carefully managing your breastfeeding. Recognise your child’s feeding cues and breastfeed whenever possible.  Empty your breast at each feeding to regularise milk production and maintain your child’s nutritional needs.

Complications

  • Hard areola and overfull breasts can prevent the baby from breastfeeding properly and lead to early weaning.
  • Low milk supply: If regular breastfeeding is not done, the milk will not be emptied and lead to a lesser milk production.
  • Breast problems: It can block the milk ducts, cause sore nipples and mastitis (inflammation of the breast).

Next Steps

Breast engorgement is temporary in nature. You can take simple measures outlined above to manage it at home. Visit your doctor, if you do not find relief from these approaches.

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References

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  • Breast Engorgement in the First Week Postpartum. Palo Alto Medical Foundation. http://www.pamf.org/children/newborns/feeding/engorgement.html. Accessed 2 Nov. 16.
  • Breast Engorgement. HealthLink BC. https://www.healthlinkbc.ca/health-topics/hw133953. Accessed 2 Nov. 16.
  • Australian Breastfeeding Association. https://www.breastfeeding.asn.au/bf-info/common-concerns%E2%80%93mum/engorgement. Accessed 2 Nov. 16.

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