What Can a Natural Mama do About Engorgement?

back to expert panel

by Karen P. Roeske, RN, IBCLC
belliesbabiesbreasts.com

What is Engorgement?

Normal engorgement of the breasts typically occurs 3-5 days after birth. This fullness may be uncomfortable and your breasts may be warm and appear larger in size. The flow of milk will be normal. Discomfort varies from woman to woman but tends to be mild to moderate during this time. Normal engorgement slowly recedes over one to two days but may possibly last up to two weeks for some women.

Why Does it Happen?

Engorgement occurs as many hormonal changes are taking place in your body. Blood flow increases to the breast, which is triggered by a surge in prolactin. Prolactin is a hormone that stimulates development of the breast and controls milk synthesis. This is accompanied by an increase in milk volume. With the rapid increase in blood flow and milk volume, swelling occurs as blood vessels leak fluid into the surrounding breast tissue. This pressure and congestion also causes an obstruction in the flow of the lymphatic drainage of the breasts.

What Can I Do About It?

Treatment or prevention of severe engorgement is focused on decreasing swelling so the capillaries can bring oxytocin (a hormone your body makes) to the milk secreting cells and allow them to contract and release milk. The application of heat increases oxytocin uptake so your milk can be released. Cold compresses cause a constriction of the blood vessels, which decreases the swelling within the breast.

Feeding your baby or expressing milk along with warm and cold therapies work well during this time. Warmth is used prior to feedings and cold is used after feedings. A warm compress or a warm shower can work wonders by allowing your body to increase its uptake of oxytocin, which will allow your milk to let down and get to your baby.

Simple things can help you make it through this normal process of engorgement. First, the most important thing is feeding your baby. Breastfeed your baby within the first hour after birth. Skin to skin contact after birth is a great way to allow your baby access to your breasts. It is amazing that babies are born with the ability to seek and latch onto the breast. Correct latching techniques will allow your baby to transfer milk adequately. Babies who are latching correctly create a tugging sensation you will feel while they suckle.

Breastfeeding your baby should not hurt. If you feel a pinching sensation, pain, or if your nipples are not round after a feeding, then most likely the latch is not deep enough. Ask for assistance from a lactation consultant or other health care provider if you experience these indications that the latch may need to be deeper. They may recommend trying the cross cradle or football hold because these positions allow you the ability to gently support and guide your baby as they latch on. Continue frequent feedings on demand, or according to your baby's hunger cues. It is not necessary to restrict the frequency or length of the feedings.

Allow your baby to finish the first breast prior to offering the second breast. This allows the milk cells to release milk to the baby decreasing the distention of the cell and thus allowing the capillary blood to circulate around the cell. If the blood flow is compromised, then the vessels leak fluid into the surrounding space creating more swelling and the transfer of oxytocin is also decreased. Adequate blood flow around the cell brings oxytocin to the cell which causes the milk cells to contract and propel the milk down the ducts to your baby.

Second, pumping can be helpful in certain circumstances. If you have mild engorgement and are feeding your baby frequently with correct latching techniques, the engorgement should resolve on its own without pumping. Pumping is used when a baby isn't able to feed adequately at the breast. Pumping time recommendations vary depending on your situation. If you have significant engorgement that is preventing latch on, you may pump for a few minutes prior to a feeding to soften your breasts enough to allow your baby to latch. If breastfeeding is going well and your baby is able to latch and transfer milk, then pumping can potentially complicate matters by stimulating your breasts to make more milk, which can prolong the engorgement process.

Third, an interesting cold therapy is to use refrigerated cabbage leaves. These can be placed on your breasts in between feedings. Many mothers state that they notice a significant decrease in swelling and an increase in milk flow with use. Cabbage leaves have been noted to decrease milk supply, so be careful to use them only for a limited amount of time.

If your breasts are very painful and your milk flow is compromised, then you must seek help from an appropriate health care provider, such as a lactation consultant. The hospital or birthing center where you had your baby will often have one on staff, or you can ask your doctor, midwife or pediatrician for a referral. Severe engorgement can cause cessation of milk production if unresolved.

Works Cited

Humphrey, Sheila. The Nursing Mother's Herbal. Minneapolis, MN: Fairview Press, 2003: 142-152.

Mannel, Rebecca, and Martens, Patricia, eds. Core Curriculum for Lactation Consultant Practice. 2nd Edition. Sudbury, MA: Jones and Bartlett Publishers, 2008: 637-640.

Riordan, Jan. ed. Breastfeeding and Human Lactation. 3rd Edition. Sudbury, MA: Jones and Bartlett Publishers, 2005:205-206.

Share Mama:

Did you like what Mama had to say? Share this page today!

Mama's TestimonialsRead More >>

"I bought my friend an Earth Mama gift basket for her baby shower and she loved it. Everybody 'oooohed and aaahhhed' at what a cool gift it was." Angelica H. Burbank, CA
"After battling with severe diaper rash for what seemed to be an eternity and trying every diaper rash cream and treatment available and ending up having to give my baby antibiotics because his skin was tearing the rash had gotten so bad, I found your Angel Baby Bottom Balm while searching online for a cure. I was skeptical at first, as I had tried so many products only to have them fail. None of them offered the relief they promised. I ordered the "Little Something for Baby's Sore Bottom" package and washed his bottom with the Angel Baby Diaper Rash Soap upon arrival and applied the balm. After one application of your Angel Baby Bottom Balm I noticed a tremendous difference by the next diaper change. By morning the redness was completely gone. Thank you so much for giving my little man the relief he needed. Your shipping was incredibly fast as I ordered late in the day and my order was shipped the same day. Again THANK YOU!!" Georgia Mom of 2
"Angel Baby Bottom Balm is more than just a diaper rash cream. I use this on my son's entire body. It works miracles for my son's eczema. I can't get enough of it!" Kia A. Hughson, CA
"I received a jar of Angel Baby Bottom Balm from my mother. I have to say, this was the best goodie yet. I used it several times on my 9 month old angel Natalie's bottom for rashes. One application right before bedtime, and by morning, the rash is gone. She also developed a yeast-type infection from her chubby thigh creases (love them!), and her pediatrician wrote a prescription for cream. I never filled it, as I tried the Angel Baby Bottom Balm and it worked - in 2 applications! I also used it on my 5 1/2 year old son, who had what appeared to be a burn on his arm, and it cleared up in a day or two. Thank you, and thank you again. You have a believer in me (and my angels)!" Carol C.
"I just wanted to send a rave review and thank you for your Bottom Balm. My son is 20 months old and for quite some time now has suffered near-chronic diaper rash. He has extremely sensitive skin and it seemed that we could do nothing to prevent the diaper rash from returning. My sister had given me a newborn gift set from Earth Mama Angel Baby that included a jar of the Angel Baby Bottom Balm; I'd just never used it. So, I gave it a try. Within a very short period of time, the balm totally cleared up my son's rash. We have been using it after every diaper change now for a month, and I have to say, the appearance of the skin on his bottom is 100% better. I've also used the balm on some of his cuts and scrapes and have noticed that they heal quicker. I just want to thank you for an incredible product. I had tried EVERYTHING on the market - every single brand of diaper cream and nothing came remotely close to your product's effectiveness. I am very into reading labels, so I also appreciate the organic and all-natural aspect of your product as well. My son asks for the balm by name. When it's diaper change time, he yells, "Bom! Bom! Bom!" and after I put it on, he will say "ahhhhh!" So thank you so much - I'm pregnant with our second baby and I will use this from the get-go with him/her." Very truly yours, S. O. Philadelphia, PA
"EMAB got me through this pregnancy! I had heartburn like you WOULDN'T BELIEVE...the Earth Mama Heartburn Tea REALLY DID help! Had a c-section and have been using the C-Mama Healing Salve&trade. I am unable to breastfeed due to medical reasons, so that No More Milk Tea came in very handy as I tried to "de-gorge" my poor boobs, who have now gone back to their droopy selves! And of course...the Angel Baby Bottom Balm. I change her and she is ALL RED, put on the Angel Baby Bottom Balm and the next change...she is white again! I'm so glad I can actually use the products. Of course Amaya, my oldest, loves her Angel Baby Shampoo and Body Wash and now I have real baby to use it on. I just wanted to let you know that you create some really sweet products! xoxox," Julie K. Portland OR
"SO, I'm emailing because I have to tell you how fabulous the Angel Baby Bottom Balm is!!!! Emily has not really suffered from diaper rash at all (we love changing her diaper), but now that she's sleeping longer at night, she did indeed get some diaper rash. I put the Angel Baby Bottom Balm on and poof! The diaper rash was gone and has stayed gone. It's FABULOUS!!!!!!!!!!!!!!!!!! And it smells great for me!!!" Leslie B.Bellybar
"I just wanted to say how much I love your products. We are very conscious of the products we use for ourselves and our baby boy, and we love how earth friendly and body friendly you have made your products. We have used the Earth Mama Bottom Balm, New Mama Bottom Spray, Angel Baby Bottom Balm, Angel Baby Oil, Natural Nipple Butter and Natural Stretch Oil and find that all of these products are top of the line. I have recommended them to all of my friends with children. Not only are your products safe, but they are incredibly effective. Thank you for making high quality products that are perfect for our angel baby and his earth mama." Jodi R. P. Castle Rock, CO
"I had my baby this past November and due to his congenital heart defect and other complications we are still in the ICU at Children's Hospital in Boston. He had gotten his first diaper rash and I brought in the Angel Baby Bottom Balm and it cleared it right up! Not only that, he gets fussy when being changed, but settles right down when I put the balm on. The nurses love the product as well and everyone raves about it. I will certainly tell everyone how wonderful it is and I can't wait to try more products. You are truly a great company. Thank you for taking the time to make such a great product, it has made our hospital life a little easier :-)" Becca mom to Jasper!
"We really love your Bottom Balm as well and that is something which I have passed onto a number of friends. It was first recommended to me by a maternity nurse here in the UK when I first had my baby and ever since I started using it, I loved it and had my mums bring back more every-time she travelled to the UK to visit me. These little jars last forever and we have them stashed everywhere - changing station, diaper bags, in the car, the pram, my purse! Since then, I have also passed on some jars to friends in Germany and Switzerland and they too have grown addicted to it. Luckily we all have families in the US to carry these little jars of love back to us. It is wonderful to have such an effective balm which is all natural and organic and doesn't smell medicated or artificial. It outperforms all the medicated stuff on the market and everyone who has tried it really loves it for their babies. A bonus side benefit - the scent (can't find the correct words to describe it but the clean smell) seems to neutralize the strong smell of older babies' wet nappies once they start weaning. We love your products and thank you and your team for being devoted to making our lives with our new angels that much more enjoyable, naturally!"
Many thanks again! Laura
"Just wanted to write and say thanks for a TERRIFIC product! I've only used the Angel Baby Bottom Balm, but am excited to try other products and wanted to let you know you have one new happy customer! I was turned on to the Bottom Balm by a friend in another state and was excited to learn at Babyworks the other day that you are an Oregon company! The Angel Baby Bottom Balm has been such a wonderful product for my son who gets very mild diaper irritation on occasion, but who also wears cloth diapers, so I had to be careful about what I put on him. Then recently I scraped my arm on a tree and used the Bottom Balm on the large scraped area. Healed me up perfectly!"
Thanks again! Kimberly P. Portland, OR
"I can't tell you how thrilled I was to receive your Angel Baby Kit. I want only the best for my angel baby and your products are it! Thanks for your wonderful baby line... I feel great about using them on my precious one." CatherineCharlestown, MA
"The nine women in my book club went bananas when I presented an Angel Baby Kit to our new mom Theresa! They loved the Earth Mama Angel Baby products!" Barb R. Tualatin, OR
"I received some Angel Baby Bath Blossoms as a gift for Christmas and used it tonight on my little angel within 20 minutes of her bath she was sound asleep!! What an amazing product!! Incredible!!!! Thank you so much I will certainly be ordering more of it!" Becky W. LaGrange, GA
"I just got my order for Angel Baby Lotion and Angel Baby Shampoo and Body Wash. It's great to finally find something safe and organic without parabens. My son's skin drank it right up and he smells so yummy. It reminds us of orange creamsicles. My husband, my baby and myself all love it. Thank you so much for providing all these great, and most of all - SAFE products." Mary C. Middletown, NY
"My baby uses your Angel Baby Lotion like it's going out of style. This the ONLY thing that works for his eczema on his poor little back. My son is happier and healthier because of you! I appreciate it beyond words!" Kristin T. General EMAB enthusiast, New Lenox, IL
"My son Tristan and I absolutely adore your products — we use the Angel Baby Lotion, Angel Baby Shampoo & Body Wash and Natural Nipple Butter daily (I put this on his cradle cap and chapped cheeks, too)! Thanks for making such amazing, worry-free products for mama and baby :)" Marianne and Tristan
"Oh my yumminess! I love the products I have ordered over the last year from Earth Mama Angel Baby!! I am constantly searching for organic options for myself and my lovely babies. I have used the Earth Mama Body Butter, Angel Baby Lotion and Angel Baby Shampoo and Body Wash exclusively for a year now. My husband LOVES the smell of our skin, and since we all smell gently of tangerines and line dried linens, who can blame him! Your products are good for the skin, the environment and greatly put my mind at ease as to what I am slathering all over my kids, and myself. Your washes and lotions are heavenly, thank you!" Andrea
"We love your Earth Mama and Angel Baby products! I used most of your Postpartum Recovery products. For more than a year we have regularly used the Angel Baby Lotion, Angel Baby Shampoo and Body Wash, Angel Baby Bottom Balm, and Angel Baby Diaper Rash Soap on our 16 mo. old daughter. We also use the Angel Baby Bath Blossoms on occasion. We love the new 1 Liter refill size in the Angel Baby Shampoo and Body Wash and wish the lotion also came in a larger bottle. Seems like we go through a ton of it! Thanks for making gentle, safe, and wonderfully-smelling products! Jennifer S. Austin, TX
"I had another Angel Baby this year and have used nothing but your products on her delicate skin. It may be just me, but she always seems to smile even wider when I use the Angel Baby Shampoo and Body Wash and finish off with the Angel Baby Lotion and Angel Baby Oil after her bath. Thank you, thank you, thank you for selling natural, chemical-free products that I can feel good about putting on my Angel Babies!" Cathy from Westmont