Engorgement and Hand Expression

Nov 22

Engorgement is unfortunately a common experience

(but common does not mean normal!)

Breasts become overly full (engorged) from too much milk OR too much bodily fluid (or both!). It’s most common in the first few days after birth, but it can happen later in your lactation journey if your milk is backed up for any reason.

Engorgement is exacerbated by:

IV fluids during labor (if your ankles are swollen after birth, your breasts are too!)
Less effective milk “removal” due to breastfeeding or pumping issues (poor latch, poor flange fit, and more)
Scheduling feedings, or skipping feedings/pumping - leading to longer intervals than your breasts can comfortably hold.

Any of this reduces milk removal, and causes milk to get “stuck” - leading to pain, inflammation and possibly plugged ducts and mastitis.

Engorgement is aided by:

Therapeutic Breast Massage (also shows hand expression - more on that below)
Breast Stretches (also called “breast gymnastics”)
- A few more on breast gymnastics in Instagram - One, Two
- A colleague and me doing breast gymnastics as the “Breast-y Pokey”
Lymphatic drainage - Video and Instagram Post
Reverse Pressure Softening - softens the areola to help a baby latch, or for pump flanges to fit better.
Cabbage Leaves and/or CaboCreme
Effective nursing and/or pumping (including the right balance of the two, and the correct flange size (almost definitely smaller than you think!), and correct pump/pump settings)

For professional therapeutic breast massage - in NJ I highly recommend Rena' Ambrose of Mend Lymphatic Massage and Wellness Services. If you are in another area, check with your local IBCLC!
More Engorgement Tips From KellyMom
And - for sure - Hand Expression - NEXT!

Hand Expression is literally a “handy” skill!

To express/collect colostrum before baby is born (starting 37 weeks in pregnancy is considered typical, but check with your healthcare provider)
To express/collect colostrum after the baby is born - especially on days 1-2 when the milk/colostrum is thick/sticky and tends to get stuck on pump parts. Hand express into a spoon or small cup every 2 or so hours and you’ll have enough to fill your newborn’s tiny tummy!
Great add-on to pumping for some extra milk/stimulation.
Great way to relieve a plugged duct or milk bleb
If you have lost power or are without your pump