I heard from Lisa on their first day after leaving hospital. I was thrilled to hear of Sophie’s arrival and that she had started breastfeeding at birth. Lisa then told me about her current feeding difficulties and how Sophie was not feeding off of her left breast as it was just too full.

We agreed for me to come and visit them at home the next day. I also helped to put a plan in place for the following 24 hours.

Engorged Breasts Are Normal but Can Make Things a Bit Tricky at First

When the breast is overly full and hard (engorged) it can often make feeding really difficult initially. This is because babies cannot attach very well and the breast can be too hard to suck on to get the milk flowing.

So mums ends up with a really hungry and upset baby, increasingly full breasts and pain from incorrect attachment, baby sliding off the breast and onto the nipple and from the fullness itself. Not a great situation, especially with exhaustion thrown in on top! You can see why the tears flow in these early days for most new mums!

It’s normal to feel a little overwhelmed if faced with this challenge. It’s a tricky situation for anyone. So give yourself a break because you are doing a fabulous job so far, but you may just lead a little helping hand along the way.

Lisa and I talked about how, in order for the breast to keep making milk, it needs to be draining the milk. If Sophie was finding it difficult to attach to the breast then it is important to express to soften the area and help the milk start flowing effectively again.

Does Expressing Early Create Too Much Milk?

Lisa was understandably concerned that expressing more would make too much milk. This is a common thought by most mums. Expressing at this stage on top of feeding will only help solve the problem, as the expression is temporary (probably only required for 48 hours) and being used restrictively it will not cause over supply.

On the other hand, by leaving the breasts get really full and not draining the milk actually sends messages to the mum’s brain to slow and in some cases stop the milk supply!

Here’s How Lisa Described the Situation

She said that she had an engorged left breast.

Next, the mentioned that Sophie not attaching well or at all to the engorged breast.

She also said that Sophie has breastfed off the non-engorged side all night and the nipple is now very sore.

Finally, she said that her left breast was rock hard and hand expression not clearing enough milk.

Here are the breastfeeding tips I gave to Lisa.

Breastfeeding Tips for Lisa: Before a Feed

Here are a few ideas that I shared with Lisa regarding what to do before a feed.

Express the engorged breast prior to every feed – make sure the areola area of the breast is quite soft and milk flowing easily before Sophie attaches onto breast.

Feed Sophie as soon as possible after you have softened the breast.

Try laid back breastfeeding style to help improve Sophie’s attachment during breastfeeding.

Keep trying Sophie on the engorged breast first, until she is happy to feed on both sides. If she starts to get upset, try and calm her and then attempt a feed on the engorged side again. If Sophie is getting upset, feed her on her favoured side.

Co-bathe with Sophie. Make sure your partner or someone is there to help you for safety. Try and breastfeed Sophie whilst in the bath, don’t forget to soften the engorged breast first. This is very relaxing and often makes the feed a nicer experience if she’s been refusing the engorged side.

The warmth of the bath can help your milk flow easier and co-bathing is often talked about like a “re-birthing” as it helps babies feel calm around the breast and can be useful for getting babies back on the breast if they have been refusing to breastfeed.

Breastfeeding Tips for Lisa: After a Feed

Here are a few suggestions that I shared with Lisa to use after Sophie feeds.

If Sophie does feed on the engorged breast but you are still feeling very hard and uncomfortable afterwards, then express until the breast feels comfortable.

If Sophie is still favouring the non-engorged breast, you will need to express the engorged side every 3-4 hours until the breast is softer and comfortable.

Use something cooling to put in your bra for around 20 minutes to help soothe the engorged side. A frozen wet face washer is a good example for this.

Ensure Sophie has a minimum of 8 feeds in 24 hours.

Next Steps for Sophie and Lisa

I will follow up with Lisa tomorrow as it’s important at this stage to get help as soon as possible to make sure the engorgement is reducing and the milk is able to keep flowing.

If you think you have engorgement contact your midwife, maternal child health nurse or local breastfeeding clinic.

How would you describe your own breastfeeding experience? Did you have to deal with engorged breasts? What questions do you have for our lactation consultant? Please join the conversation here or on our Medela Australia Facebook page.

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