Engorgement is common in the first week after delivery. Rather than a swelling caused by milk, it is an increase of fluid in the breast brought on by the same hormones which transition your colostrum to transitional and mature milk.
Extra fluids from labor (IV fluids) and some medications can increase this fluid retention. You might also notice it in your hands and ankles/feet. It tends to peak on day 5 after birth.
Sometimes, early mastitis is mistaken for engorgement. If you are still engorged after the first week, contact your Lactation Consultant to discuss what’s going on.
To reduce the engorgement very gentle massage can be helpful.
Wearing a soft and supportive garment like a bra without wires or a nursing tank is also helpful.
Frequent feeding will keep your milk flowing and contribute to breast softness. Aim for every 2 hrs, with rest in between. It’s important to let your breasts rest and the rest of you, too! We all need to sleep and rest to recover properly and ensure long-term milk production.
Excessive pumping will increase the engorgement. Instead try hand expression for a few minutes.
Diuretic foods (foods that help you urinate frequently) can also help. These can include melons, cucumber, lettuces and dark leafy greens. Avoid caffeine and salty foods.
If the feeling persists, the use of Tylenol and cold packs can provide some relief. Avoid excessive heat on the breast.
If not resolved with these measures contact your provider and lactation consultant. Therapeutic ultrasound can be helpful or your doctor may prescribe a single dose of Pseudoephedrine 10-30mg to relieve symptoms.
If your breasts are too full for baby to latch well, reverse pressure softening around the nipple may be helpful.
Hand expressing a little bit of milk may also be helpful.
Avoid: Pumping often (milk is not causing the fullness), firm or excessive massage, heat packs (increases inflammation).
You should feel better soon with these tips!