Comfort Measures for Severe Engorgement

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A labor that included an IV of fluids may cause postpartum edema in your feet, hands AND breasts. This type of breast swelling is not normal and is referred to as engorgement. The breasts and areola are firm. The skin is stretched and tight. Under these conditions, most babies are not able to breastfeed because it’s difficult to draw the breast into the mouth. The areola needs to be soft enough for the baby to compress the tissue and maintain a vacuum.

If you find yourself in this situation, remember that warm will increase milk flow and cold will decrease inflammation. Use warmth before and during pumping/massage/breastfeeding and use cold after breastfeeding to reduce swelling.

Green cabbage leaves feel good and reduce swelling. Place cabbage leaves on the breasts avoiding nipples. Place a cool, damp cloth over the cabbage leaves. Another option is to wear the cabbage under your bra until the leaves wilt. Replace as necessary.

Place ice packs (frozen peas work great!) on your breasts—with a towel between the ice and your skin.

Gently massage the breast, moving from the outer portion of the areola toward the nipple. This will make the areola softer and easier for the baby to grasp.

Use a breast pump on a low setting to soften the areola and remove some milk. Be gentle! Remember that most of the swelling is due to water, blood and lymphatic fluid. Even after milk is removed, you will still feel the swelling.

If you find yourself severely engorged and your baby cannot breastfeed, get help from a lactation consultant. The engorgement will decrease in 48 hours or so, but in the mean time, you will need support!

Written by Renee Beebe, M.Ed., IBCLC. Renee is a lactation consultant in private practice in Seattle, Washington. She is available for home/hospital visits and phone consultations. Renee can be reached at www.second9months.com

See also, “What is a Lactation Consultant?

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