When you're a new breastfeeding mom, it's common to feel anxious for your milk to "come in." Those first few days you're only working with colostrum, the first milk your breasts make. Although a newborn's stomach is quite small (and colostrum packs a punch), you worry they're not getting enough. However, the relief you feel when your breasts finally fill with milk can quickly be replaced by the horror of engorgement. I was wholly unprepared for this experience, and there are many things I wish I'd known about engorgement before it actually happened to me.
My initial breastfeeding sessions were incredibly stressful. My baby had some trouble latching, so my nurse was squeezing my nipple onto a spoon and poking those few drops into my newborn's craw. It was highly unpleasant. I was also fumbling with a nipple shield, so I didn't feel very confident about nursing when I left the hospital. I honestly don't remember how long it took (for most moms, it's 2-3 days), but I vividly recall the bizarre shape and feel of my breasts when my milk finally "came in." Keep in mind that I've always been small-chested, and suddenly those bad boys were huge. Huge and, well, painful.
I think it's high time expectant mamas got some straight talk on engorgement, (because, honestly, motherhood is stressful and confusing enough as it is), so here goes.
It's Actually A Sign Lactation Is Going Well
It's sort of counterintuitive that something causing you so much discomfort could actually be a good sign. First things first: you have to remember that engorgement is completely normal. Basically, you're now producing prolactin, a hormone that stimulates milk production. As your boobs fill with that liquid gold, they can become warm, heavy, and uncomfortable. But all that means is that your breasts are functioning the way they're supposed to.
*Engorgement is not always a good thing. You want to keep an eye on it so you don't develop a breast infection.
You Might Not Leak
Leaking is one of the body's ways of relieving engorgement. It makes sense that breast milk might drip out of one's teeming breasts. Mine were so full, I was sure I'd have a problem. I stocked up on nursing pads and tucked them into my bra the first several days. However, I didn't leak. At all. It just goes to show that what's normal for one woman isn't the alway the same for another.*
*"Wait, Kimmie, are you saying that multiple truths can exist?" Yes, yes I am.
My Breasts Would Feel Hard As Rocks
Oh sweet baby Jesus, why has my breast tissue been replaced with quartzite (*Googles hardest types of rocks*)? But that special kind of rock, you know? Like the type that throbs. Let me tell you, it is seriously disconcerting to be able to knock on your own boobs.
Hot Showers Don't Work
Whaaaaa? But my mom told me to stand in a steaming hot shower and let the milk flow. I know, friend. Mine too.
Let me say that I did try this, and it didn't work at all for me. Now that I've done a little more research, I've found that it's not always advisable. It can increase stimulation (which equals more milk), and the heat can exacerbate inflammation. You might get some temporary relief, but it's not worth it in the long run. If you need the heat, keep it at a minimum.
Cabbage Leaves Are Apparently A Thing
OK, so no hot showers. Fortunately, there's plenty you can do to relieve engorgement. You can try cold compresses, gentle breast massage, or pain relievers. Another option: cabbage leaf therapy. For reals. You put a few cabbage leaves in the freezer, crunch the leaf in your hands, place it in your bra, and remove it when it's wilted. Voila!
*Full disclosure: I haven't tried this, but if I'd known about it I wouldn't have hesitated to turn my nursing bra into a wedge salad.
Pumping Can Make It Worse
Be very careful here, my friends. While pumping will provide you with some immediate relief, it also stimulates breast milk production and can cause you to overproduce. You want to do just enough to be comfortable and no more.
In this case, a manual pump or hand expression may be a better choice than the electric version. However, if you're not getting any relief from engorgement, you'll want to pump to make sure you don't damage your supply. It's a delicate balance, and a slippery slope.
Breastfeed More Not Less
When you're in the midst of painful engorgement, the last thing you want to do is let your newborn anywhere near your boobs. Sadly, the absolute best thing to both prevent and ease engorgement is to nurse your baby on demand. The whole reason you're engorged is because you're making more milk than your baby is consuming, so feed that hungry baby frequently and your engorgement should diminish.
Massaging While Nursing Provides Sweet, Sweet Relief
I bought a little massager for labor and didn't use it once. However, I was glad to have it postpartum. It really helped soften my breasts up. While I was nursing, I would gently massage my breasts by pressing in a downward motion on the side my baby was nursing on, and it helped get my milk flowing. Generally, rolling and kneading techniques are recommended.
It Doesn't Last That Long
Luckily, engorgement passes fairly quickly for most breastfeeding mothers. You're probably looking at 24-48 hours if you're nursing, more if you're not. It's nice to know that, as with many pregnancy and postpartum issues, it's a "this too shall pass" situation. So hang in there, SpongeMom SquareBoobs, and don't let anyone tell you you're not tough as hell.