Engorgement

Breastfeeding is wonderful, breastfeeding is great. But, when I talk to some moms about their breastfeeding plans, they tell me that they do not have any intention to breastfeed. And that’s okay, however,  research has shown that the intention to breastfeed is a predictor of breastfeeding success.[1Intention is a powerful thing because if a mom plans to breastfeed before she has her baby, then she is more likely to initiate breastfeeding after birth and be successful, as opposed to breastfeeding without any plans.[1

[Okay, back from my health educator soap box].  

When I discuss breastfeeding intentions with moms, many say that they don’t want to “because of the pain”.  Sometimes they are referring to nipple pain, which can be an easy fix. Other times they’re referring to general breast pain, which can’t be prevented, but there are some tricks to hasten the pain. However, sometimes they are referring to a pain in the breast called engorgement. Engorgement usually occurs when there is a build up of milk in the breast, which results in breast pain. [2] The breasts are often hard, shiny, warm and markedly painful. The pain is usually the most alarming when the “milk comes in” a few days after delivery. It can also occur when the milk isn’t emptied regularly, such as when you wake up in the morning or when you are away from your baby for long periods of time. Frequent emptying of milk from the breast can prevent engorgement. However, once you experience engorgement, one pumping or nursing session may not immediate alleviate the pain associated with engorgement.In fact, it can take several pumping or nursing sessions to reduce the size of the breast and pain.

But wait, what do you do in between feeding and pumping while you wait for your breasts to empty? Breast massage is a great way to alleviate pain due to engorgement. [3,4,5,6,7,8,9,10] When I was nursing my daughters, I can attest that when I awoke to find that I had gone from a C to a Double D – I would use breast massage to get the milk out quickly and alleviate the pain associated with engorgement.

Research has shown the most common breast massage techniques used for engorgement are Reverse Pressure Softening, Sliding, and Gua-Sha. Reverse Pressure softening is used to assist the baby latch by grabbing the breast near the  areola like a flower and pressing inward for a few minutes. [11-13]. The Sliding technique is when the hands, palms or knuckles slide down toward the areola in an effort to alleviate several breastfeeding problems including low milk supply. [14, 15] Gua-Sha is a method in which the mother scrapes the acupoints in the direction toward the nipple to alleviate engorgement. [16].

Engorgement can be uncomfortable and untreated can lead to mastitis. If you are experiencing problems associated with breastfeeding, speak to your doctor or lactation consultant.  

 

Hope this helps.

(.) (.)

Ileisha Sanders, mother of 2

LiquidGoldConcept COO

 

  1. Digirolamo A, Thompson N, Martorell R, Fein S, Grummer-Strawn L. Intention or Experience? Predictors of Continued Breastfeeding. Health Education & Behavior 2005;32(2):208–226.
  2. Breast Engorgement-Overview. WebMD. Available at: http://www.webmd.com/parenting/baby/tc/breast-engorgement-overview. Accessed March 4, 2016.
  3. Storr G. Prevention of Nipple Tenderness and Breast Engorgement in the Postpartal Period. Journal of Obstetric, Gynecologic & Neonatal Nursing. 1988;17(3):203­209. doi:10.1111/j.1552­6909.1988.tb00426.x.
  4. Kabir N, Tasnim S. Oketani Lactation Management: A New Method to Augment Breast Milk. Journal of Bangladesh College of Physicians and Surgeons. 2010;27(3). doi:10.3329/jbcps.v27i3.4293.
  5. Bolman M, Saju L, Oganesyan K, Kondrashova T, Witt A. Recapturing the Art of Therapeutic Breast Massage during Breastfeeding. Journal of Human Lactation. 2013;29(3):328­331. doi:10.1177/0890334413475527.
  6. Applebaum R. The Modern Management of Successful Breast feeding. Pediatric Clinics of North America. 1970;17(1):203­225.
  7. Applebaum R. The Obstetrician’s Approach to the Breasts and Breastfeeding. The Journal of Reproductive Medicine. 1975;14(3):98­116.
  8. Chiu J, Gau M, Kuo S, Chang Y, Kuo S, Tu H. Effects of Gua­Sha Therapy on Breast Engorgement. Journal of Nursing Research. 2010;18(1):1­10. doi:10.1097/jnr.0b013e3181ce4f8e.
  9. Cotterman K. Reverse Pressure Softening: A Simple Tool to Prepare Areola for Easier Latching During Engorgement. Journal of Human Lactation. 2004;20(2):227­237. doi:10.1177/0890334404264224.
  10. Jevitt C, Hernandez I, Groer M. Lactation Complicated by Overweight and Obesity Supporting the Mother and Newborn. Journal of Midwifery & Women’s Health. 2007;52(6):606­613. doi:10.1016/j.jmwh.2007.04.006.
  11. Jevitt C, Hernandez I, Groer M. Lactation Complicated by Overweight and Obesity: Supporting the Mother and Newborn. Journal of Midwifery & Women’s Health. 2007;52(6):606­613. doi:10.1016/j.jmwh.2007.04.006.
  12. Bolman M, Saju L, Oganesyan K, Kondrashova T, Witt A. Recapturing the Art of Therapeutic Breast Massage during Breastfeeding. Journal of Human Lactation. 2013;29(3):328­331. doi:10.1177/0890334413475527.
  13. Cotterman K. Reverse Pressure Softening: A Simple Tool to Prepare Areola for Easier Latching During Engorgement. Journal of Human Lactation. 2004;20(2):227­237. doi:10.1177/0890334404264224.
  14. Applebaum R. The Modern Management of Successful Breast feeding. Pediatric Clinics of North America. 1970;17(1):203­225.
  15. Applebaum R. The Obstetrician’s Approach to the Breasts and Breastfeeding. The Journal of Reproductive Medicine. 1975;14(3):98­116.
  16. Chiu J, Gau M, Kuo S, Chang Y, Kuo S, Tu H. Effects of Gua­Sha Therapy on Breast Engorgement. Journal of Nursing Research. 2010;18(1):1­10. doi:10.1097/jnr.0b013e3181ce4f8e.

Featured image by Evan-Amos

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