You'll be surprised to know that engorgement is not entirely just breasts full of milk. The accumulation of milk is part of it, but engorgement also involves increased blood supply and swelling of the breast tissue itself.

• The bad news is you're hard, lumpy and tender.
• The good news is that it only lasts 24 to 48 hours.
• The main thing you want to accomplish during this time is to get the milk out of the breast. Leaving the milk in decreases your milk production.

Recommendation for Engorgement

• Prevention: Breastfeed often giving your baby unrestricted feeding time.
• Heat: Take a warm shower or apply heating pads or warm packs to your breasts before breastfeeding. To make a convenient warm pack fill a couple of disposable diapers with warm water or heat a wet towel in the microwave (one-two minutes).
• Hand express gently around the nipple to release some milk so the nipple is soft enough for your baby to latch onto. You may also have to squeeze the nipple between two fingers to make it easier for your baby to latch onto.
• Pump your breasts with an electric or manual breast pump prior to nursing to soften the nipple and initiate a letdown of milk. Pump again after nursing to empty what the baby was unable to take until you're soft and comfortable again.
  
  
• Nurse more frequently (every 1-2 hours) and longer at each feeding (20+ minutes, provided you are not experiencing extreme nipple tenderness).
  
  
• Hand massage the milk toward the nipple with the palm of your hand prior to and during breastfeeding.
• Finally, a mild pain reliever such as Tylenol or Ibuprofen will bring relief without bothering your baby.

Remember, getting the milk out is your goal during engorgement. By doing this you are not adding to engorgement which is a temporary overproduction of milk and congestion in response to your milk coming in. You are simply relieving the pressure and maintaining your milk supply until this temporary condition subsides. The baby's sucking demands will soon dictate how much milk you supply.

Patricia Grant, R.N., C.L.E.
© COPYRIGHT 1995, Bosom Buddies, Inc. Denver, CO 80218