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During the first few weeks after
delivery as the Colostrum "starter milk"
is changing to mature milk, your breasts will
become full. This normal postpartum fullness
usually diminishes within 3-5 days. Engorgement
can occur if your baby does not adequately remove
milk from your breasts. This causes your breasts
to feel hard, painful and hot. This is due in
part to extra blood and swollen lymph nodes,
not entirely to accumulated milk. Excessive
fullness of the breasts can also lead to swollen
areolas (the dark area around the nipple) and
flattened nipples, making it difficult for the
baby to latch-on, causing sore nipples.
PREVENTION
You can prevent engorgement by following these
simple guidelines: Breastfeed your baby frequently,
8-12 times in 24 hours. If you miss any feedings,
express your milk, and when weaning your baby,
do so gradually.
TREATMENT
Engorged breasts can be treated in several
ways. Try applying hot, moist towels to your
breasts for a few minutes, or taking a hot shower
before nursing your baby. After using moist
heat, hand-expression of milk will help soften
the areola, making it easier for the baby to
latch-on to your breast. You may also want to
use gentle massage, deep breathing, soft music
or other relaxation techniques before and during
nursing. Icy cold compresses applied to your
breasts can relieve discomfort and swelling
after breastfeeding.
If your baby takes only one breast, you can
alleviate engorgement of the breast that is
not nursing by using a breast pump or by hand
expressing milk. If your baby cannot latch-on
or your nipples are flattened, breast pump or
hand expression to soften the areola. Use moist
heat and breast massage before expressing. Continue
expressing every two hours, 10 minutes per breast,
until your baby can latch-on.
Avoid bottles, pacifiers and nipple shields.
These may cause nipple confusion/preference.
Wearing a proper fitting, supporting nursing
bra will make full breasts more comfortable
and prevent the discomfort of engorgement.
If you have further problems, contact your health
care professional or breastfeeding specialist.
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