Managing engorgement

A large proportion of the families I work with are in the very early days of life with a new baby. This can often feel overwhelming as day and night can blur into one as the emotions of having a new baby join the family, recovery from birth and sheer level of tiredness all combine.

One particular problem that can often add to the stress is early days engorgement. This is experienced as breasts which become overly full with milk making them hard, heavy and painful. In some cases, babies can then find it tricky to latch onto a breast as it is almost like trying to latch onto a beach ball!

Engorgement, though painful, can easily be managed through effective feeding. Step one is to keep feeding your baby responsively. As a reminder, responsive feeding means feeding in response to feeding cues from your baby (bringing their hands to their mouths, opening and closing their mouths, turning their heads and crying, which is a late feeding cue) and also in response to your breasts feeling full. Remember, newborn babies need to feed at least 8 times in 24 hours so, if you have a sleepy baby, keep them waking them at least every 3 hours. In between feeds use cold compress on your breasts to help relieve inflammation and use gentle stroking massage towards your armpits to help drain fluid through the lymphatic system.

If your baby is struggling to latch then use a little hand expression to help soften the breasts before latching. Reverse pressure softening is also a useful tool to help move fluid away from the nipples.

As your baby continues to feed effectively engorgement should ease by itself but, if problems aren’t improving, do seek help from your midwife, an IBCLC or health visitor.