Top Tips For Engorgement

“My newborn baby just wants to feed all the time”. As a Nurse & Midwife, I hear this all the time!  It is true and very normal!  When a baby is born their tummy is very tiny, like the size of a marble!  The first milk your breasts produce is called colostrum and it is very low in volume, babies maybe only get a teaspoon or two during a feed. Colostrum looks a little more yellowish in colour and while it may be low in volume it is high in fats and calories.  Colostrum is thought to be 30x more potent than breastmilk. 

We feed our new babies often because their tummies are tiny (which matches our lower milk volume), so they feel full faster but feel hungry again sooner!  It is completely normal for them to want to feed frequently and those frequent feeding sessions is what helps establish our milk supply.  The more stimulation our breasts get the more milk they make, that demand and supply system!!  So, as exhausting as it is feed your newborn every few hours (or less!) it is what they need to maintain their weight and what you need to establish a great milk supply.  

Babies will always lose a percentage of their birth weight, so you will almost always take a baby home from the hospital lighter than they were born.  As long as that weight loss is within the appropriate percentage, we are good to go.  Your baby will follow up with their doctor for sure at 14 days.  This visit is really important because we want babies to be back to their birth weight by 2 weeks of age.

By day 4, your little one’s tummy is now about the size of a ping pong ball!!  Crazy how fast it grows!!  Right around that same time, days 3-5 postpartum (maybe more like days 5-7 for c-section moms), your milk supply comes in!!  All those frequent feeds in the first couple of days start to pay off and just in time as your babies’ tummy is bigger and their milk volume requirements have increased.  

Sometimes when the milk comes in moms end up with breast engorgement.  The milk can come in really fast; you could be at home and your breasts still feel softer with just the colostrum, you decide to take a nap and you wake up from the nap with big, heavy, firm breasts…and the milk is in!  Some moms will really notice and be bothered by this engorgement, others not as much.

Engorged breasts not only feel firm and full but can also feel hot and moms may have a low-grade fever.  Engorgement will settle within 12-24 hours.  That can feel like a long time, so here is what you can do to help:

• Feed often to empty breasts.
• If you are having trouble getting the baby to latch due to breast fullness try some reverse pressure (gently pushing back the tissue around the nipple).  Or hand express to soften the breast for the latch.
• If you are going to pump for comfort, keep in minimal because pumping may make more milk!!  Pump for 5 or 10 minutes only.  Hand expression, especially in a warm shower, may just be a better idea to empty the breasts for comfort.
• Ice to breasts…20 minutes on, 20 minutes off.
• You can take Tylenol or Advil to help relieve some of the discomforts.
• For extreme engorgement where the above isn’t enough, you can apply cabbage leaves to settle the volume of milk.  You would put the cabbage leaves in the fridge and apply the cool leaves to your breasts until they are wilted (about 20-30 minutes).  You could do this 3-4 times/day, but be careful with this one as the milk supply is very fragile.  You don’t want to overdue settling the milk supply and swing things in the opposite direction of a low milk supply.

Hang in there, your body will realize what exactly your little one needs for milk supply and your body will adjust the milk volume accordingly.  If you are struggling with engorgement, have any milk supply issues, or need support with feeding your baby please reach out, I am happy to help!