Breast engorgement

This article is contributed by Ms May Hui May Lin

1. What is primary engorgement?
It is common to have engorged breasts on day 3-5 after delivery (usually day 4-5 for first time mother and day 2-3 for second time mother). The breasts become big, tense, heavy, slightly hard and slightly uncomfortable. Most important of all, the milk is able to come out easily. This condition will settle down after 1-2 days. It happens because the breasts are ready to produce more milk for her baby.
However, during this period, if the baby is not sucking correctly or if the mother tries to use the breast pump to get the milk out, secondary engorgement may occur.

2. What are the signs and symptoms of secondary engorgement?
Apart from the painful, hard, swollen breasts, the milk flow has slowed down or may have stopped. This condition will get more and more serious. It usually happens within 3 weeks after delivery. If the milk still cannot drain out properly, there is a high chance of Block ducts very soon. White spot or soreness may be seen on the nipple in some cases. Pumping is not the correct way to treat this condition. It is only when the baby can suck correctly that this condition can improve.

3. Why shouldn’t we use breast pump during the first month after delivery?

  • Pumping will increase the milk supply, thereby not helping to relieve the engorgement. The sucking mode of the pump is either 50 cycles or 100 cycles in 1 minute. It is not physiological as the baby cannot suck that fast.
  • Pumping cannot drain the milk out effectively. Both the colostrum in the first few days and the breast milk in the first month are rather thick. The pump will elongate the nipple, making the outlets narrower. Hence, the thick milk cannot be emptied effectively. It is different from sucking by the baby and hand expression of milk.

4. How can we prevent and treat breast engorgement?
Immediately after delivery, put baby to the breast in a correct position which will help to drain the milk out properly.

If block ducts are present, use hand expression, which is more effective to drain the milk out. Before the hand expression, apply a hot (80 degree) towel to the breast first but be aware not to get burned. After hand expression or feeding, apply ice pack for 10 minutes to reduce pain and inflammation. Consult doctor or Lactation Specialist if the condition does not improve.

updated on 28.09.2020