Breast Engorgement

Breast engorgement is the painful overfilling of the breasts with milk. This is usually caused by an imbalance between milk supply and infant demand. This condition is a common reason that mothers stop breast-feeding sooner than they had planned but it shouldn't because it's a phase that will definitely pass.

Engorgement can happen:

-When milk first "comes in" to your breasts, during the first few days after birth.
-When you normally have a regular breast-feeding routine but cannot nurse or pump as much as usual.
-If you and your baby suddenly stop breast-feeding.
-When your baby's breast-feeding suddenly drops, either when your baby is starting or increasing solid foods or when the baby is ill with a poor appetite.

As you get close to your due date, your breasts make colostrum. Colostrum is a yellowish liquid that contains important nutrients and antibodies that a baby needs right after birth. About 2 to 5 days after your baby is born, your breasts start making milk for your baby. When your milk comes in, your breasts will most likely feel warm and heavy. Some women feel only slight swelling. Others feel uncomfortably swollen.

If don't breast-feed after your baby is born, you will have several days of mild to moderate breast engorgement. This gradually goes away when the breasts are not stimulated to make more milk.

Overfilled breasts can easily become very swollen and painful, leading to severe engorgement. Common causes of severe engorgement are:

-Waiting too long to begin breast-feeding your newborn.
-Not feeding often enough.
-Small feedings that do not empty the breast well. Babies who are fed formula or water are less likely to breast-feed well.

Breast Engorgement-Symptoms
Severe engorgement can make it difficult for your baby to latch on to the breast properly and feed well. This can make the problem worse. As a result:

Your baby may not receive enough milk.
Your breasts may not empty completely.
Your nipples may become sore and cracked. This is caused by your baby's attempts to latch on to your overfull breasts. If you then breast-feed less because your nipples are sore, the engorgement will increase.
Without treatment, severe engorgement can lead to blocked milk ducts and breast infection, which is called mastitis.

¤Easing the pain of engorgement
*Soak a cloth in warm water and put it on your breasts. Or take a warm shower. This techniques, when used just before breastfeeding or expressing milk, will encourage milk flow.
*Warmth may not help in cases of severe engorgement. In this case, you may want to use cool compresses in between or just after feeding.
*Express milk or pump just enough for comfort's sake.
*Feed on demand not following routine feeding.
*Try feeding your baby in more than one position. Begin by sitting up, then lying down. This changes the segments of the breast that are drained most optimally at each feeding.
*Gently massage your breasts from under the arm and down the nipple. This will help reduce soreness and ease milk flow.
*Wear a supportive bra (not too tight though).
*I read about the use of cold cabbage leaves. Keep the cabbage leaves in a refrigerator and place next to the breasts in your bra. (I never got to try it but I have heard many people's testimony of the cabbage therapy).
*You may use a mild and safe pain relieving medicine (with your doctor's approval).

Fortunately, engorgement lasts only a few days while lactation is getting established. However, it can occur any time, when feedings are skipped and the breasts are not emptied frequently or when weaning your baby.

References:
WebMD
AAP