Reverse pressure softening for primary engorgement
by Cordelia Uys
Mature milk coming in
When their mature milk starts coming in, which for first time mothers is usually around day 3 or 4, but can be a bit earlier for women who’ve already had a baby, some women notice their breasts suddenly becoming much larger and firmer; for others it’s a more gradual process. The increase in size is due to extra lymph fluid and blood flowing in as breasts fill with mature milk. They may also notice the veins on their breasts becoming more prominent.
To avoid extreme engorgement
Breastfeed within 2 hours of your baby’s birth.
Breastfeed often: aim for 10 to 14 feeds (or more) in 24 hours.
Avoid going longer than 3 hours between feeds.
Offer both breasts at each feed.
Ensure your baby is well-latched and positioned and transferring milk effectively. Ask for help if not.
Engorgement can be alarming
Having breasts that are rock-hard, warm and tender, can come as a shock. Some women also experience painful swelling in the breast tissue under their armpits, and some develop a fever.
Many women feel tearful and overwhelmed as a cocktail of new-mum hormones course through their body. The engorgement and emotional volatility usually only last 24-48 hours.
Your baby might suddenly not longer be able to latch
The engorgement can cause the nipple and areola to swell up so much that the nipple disappears, so for the baby it’s like trying to latch on to a pumped-up football.
How to relieve the engorgement
If normally tolerated, you can take ibuprofen.
Breastfeed every ½ to 2 hours during the day, and every 2 to 3 hours at night.
Gently massage your breasts during feeds.
Between feeds
Apply cold compresses: 20 minutes on, 20 minutes off.
For the compresses: pour cold water into two clean disposable nappies, place in the freezer for an hour, and then apply one to each breast: https://www.instagram.com/p/CgjUvzugHxD/?utm_source=ig_web_copy_link
Pour cold water into a clean, disposable nappy and place in the freezer for an hour.
Before feeds
Pour warm water in a clean nappy and apply to the breast you’re going to feed from for 2 minutes, not more. This encourages the milk to flow.
Do 3 minutes of reverse pressure softening: place the tips of your index fingers and the tips of your middle fingers on each side of the base of your nipple, and press on your areola, so your nipple stands proud. This is very effective at releasing pressure and should allow your baby to latch.
If your baby still can’t latch, gently hand express a bit of milk.