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Breast Engorgement

The Breast Engorgement Cycle

Typically, one to three days after giving birth (although it can be up to seven days), your breasts will begin producing large quantities of milk. It is normal for your breasts to become larger, get heavier, and feel sore. This fullness should decrease by the first or second week after giving birth if your baby is breastfeeding regularly and well. If not, this fullness could turn into engorgement and feel uncomfortable.
When this happens, the fullness can be painful. It can even make it difficult for your baby to latch on effectively because the nipple has flattened out due to the fullness of your breast. If the nipple flattens out, your baby may have difficulty getting the proper part of the nipple in her mouth to latch correctly.
This can create a painful and frustrating cycle that results in a decrease in milk production, sore nipples, and increased hunger in your baby. If this happens, you should work on treating the engorgement right away (see Breast Engorgement Treatment).

Symptoms of Breast Engorgement

Signs and symptoms of breast engorgement can vary. Some possible indications include breasts that are:
  • Firm
  • Warm to the touch
  • Throbbing
  • Uncomfortable or painful.
Some women also will have a low-grade fever (under 101ºF or 38.3ºC).

How to Prevent Engorgement

It may be possible to prevent breast engorgement by:
  • Breastfeeding your baby soon after birth.
  • Nursing often in the beginning. Have your baby stay with you in the room while in the hospital so you can nurse often. Ideally, you should nurse 8 to 12 times every 24 hours in the beginning.
  • Manually expressing milk (by hand) or pumping between feedings.
  • Ensuring correct positioning and latch-on. Your baby's mouth should take most of the nipple in for a good latch. If you feel pain or pinching during breastfeeding, stop and ask for help from your nurse or a lactation consultant.
  • Wake your baby at least every two to three hours during the day and every four to five hours at night in the beginning. Frequent nursing removes the colostrum and incoming milk so that normal postpartum fullness does not develop into painful engorgement.
If you do experience breast engorgement, don't think you have done anything wrong. It tends to happen with most new moms.
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