Engorgement
Breastfeeding Housecalls can help you relieve your engorgement by using strategies which can help empty your breasts and help you and your baby find a comfortable way to nurse.I'm engorged! Now what?
The best answer could be "Feed the baby!". However, some moms could be told this all day long, and their babies could have been fabulous feeders prior to her milk coming in, but now baby "just won't latch".
In order to understand this, lets better understand "engorgement". There's a difference between being "full" and being "engorged", and any mother who has ever been engorged (some moms never get engorged, and that's usually ok) knows exactly the feeling.
Because a baby's belly is so tiny (it is believed it can hold a grape-sized volume of colostrum), colostrum is made only in small amounts. The first few days of nursing are about transferring immunity via colostrum and about stimulating the baby's gut to empty their bellies and intestines from what's been collected in there since pregnancy. Sucking and swallowing stimulate gut hormones in the baby which cause the belly to empty and the gut to move out meconium (sticky black poop that looks like tar during a baby's first few days of life). So what does small colostrum intake and sticky poops have to do with engorgement? A lot.
Once your baby's gut has moved around enough and has cleared out its content from having been inside you, miraculously baby's belly starts expanding...and in reply, mom's milk transitions from colostrum to more mature milk. When a baby has not been emptying his mother's colostrum often (as often as he wants to) in the early days, some moms experience a "back up" (engorgement) in their breast. Interestingly, engorgement isn't only about lots of milk, engorgement actually also comes from tissue inflammation and excess blood hanging around near mom's breast (Where else do you think breastmilk ingredients come from? Mom's blood! How cool!).
Although not nursing enough during the first few days is usually a reason why moms become engorged, engorgement can also happen for other reasons. Most moms retain fluids to a degree during pregnancy (and in our society even moreso when fluids are introduced via IVs if a mother births in a hospital). These fluids can accumulate in the breasts, areolas and nipples and cause swelling which can compress milk ducts and cause less colostrum from being released. If you experience breast swelling due to fluid retention, you can apply warm compresses over your breasts and areola BEFORE nursing to help your breasts, areolas and nipples become more pliable for your baby to nurse from. Also, warm compresses can make your breasts, nipples and areolas more pliable for pumping. However, try not to use warm compresses on your breasts if you don't intend to empty them immediately afterward, as this could cause more milk to be produced by already engorged breasts.
Rarely, when moms have pierced nipples, or previous breast or nipple infections, ducts could be blocked by scar tissue. If you suspect this is your situation, be assessed by an International Board Certified Lactation Consultant (IBCLC) immediately for strategies to ease your engorgement and optimize your milk production, and your babies breastmilk intake.
Why is "Engorgement" a critical time?
Interestingly, nature is energy efficient. They have equipped most mothers with a "gauge" that regulates a hormone called the Feedback Inhibitor of Lactation (FIL) so that no energy is ever wasted. The FIL is usually our friend because it prevents an over abundance of milk to be made and helps regulate your milk production to what you and your baby demand of it. However, in cases where not enough milk is drained from the breast the FIL is our foe because it tells the body to halt milk production since the breast is not actually being emptied.
Another reason why the engorgement period is critical is because when babies can't latch onto a non-pliable nipple, they still need to eat! Understandably parents reach for the bottle, leading to even less emptying of a mother's breast. We know that every drop of formula given is a drop less that your breast gets to make of breastmilk and, like mentioned above, nothing alerts the FIL gauge to kick in like an unemptied breast!
The best answer could be "Feed the baby!". However, some moms could be told this all day long, and their babies could have been fabulous feeders prior to her milk coming in, but now baby "just won't latch".
In order to understand this, lets better understand "engorgement". There's a difference between being "full" and being "engorged", and any mother who has ever been engorged (some moms never get engorged, and that's usually ok) knows exactly the feeling.
Because a baby's belly is so tiny (it is believed it can hold a grape-sized volume of colostrum), colostrum is made only in small amounts. The first few days of nursing are about transferring immunity via colostrum and about stimulating the baby's gut to empty their bellies and intestines from what's been collected in there since pregnancy. Sucking and swallowing stimulate gut hormones in the baby which cause the belly to empty and the gut to move out meconium (sticky black poop that looks like tar during a baby's first few days of life). So what does small colostrum intake and sticky poops have to do with engorgement? A lot.
Once your baby's gut has moved around enough and has cleared out its content from having been inside you, miraculously baby's belly starts expanding...and in reply, mom's milk transitions from colostrum to more mature milk. When a baby has not been emptying his mother's colostrum often (as often as he wants to) in the early days, some moms experience a "back up" (engorgement) in their breast. Interestingly, engorgement isn't only about lots of milk, engorgement actually also comes from tissue inflammation and excess blood hanging around near mom's breast (Where else do you think breastmilk ingredients come from? Mom's blood! How cool!).
Although not nursing enough during the first few days is usually a reason why moms become engorged, engorgement can also happen for other reasons. Most moms retain fluids to a degree during pregnancy (and in our society even moreso when fluids are introduced via IVs if a mother births in a hospital). These fluids can accumulate in the breasts, areolas and nipples and cause swelling which can compress milk ducts and cause less colostrum from being released. If you experience breast swelling due to fluid retention, you can apply warm compresses over your breasts and areola BEFORE nursing to help your breasts, areolas and nipples become more pliable for your baby to nurse from. Also, warm compresses can make your breasts, nipples and areolas more pliable for pumping. However, try not to use warm compresses on your breasts if you don't intend to empty them immediately afterward, as this could cause more milk to be produced by already engorged breasts.
Rarely, when moms have pierced nipples, or previous breast or nipple infections, ducts could be blocked by scar tissue. If you suspect this is your situation, be assessed by an International Board Certified Lactation Consultant (IBCLC) immediately for strategies to ease your engorgement and optimize your milk production, and your babies breastmilk intake.
Why is "Engorgement" a critical time?
Interestingly, nature is energy efficient. They have equipped most mothers with a "gauge" that regulates a hormone called the Feedback Inhibitor of Lactation (FIL) so that no energy is ever wasted. The FIL is usually our friend because it prevents an over abundance of milk to be made and helps regulate your milk production to what you and your baby demand of it. However, in cases where not enough milk is drained from the breast the FIL is our foe because it tells the body to halt milk production since the breast is not actually being emptied.
Another reason why the engorgement period is critical is because when babies can't latch onto a non-pliable nipple, they still need to eat! Understandably parents reach for the bottle, leading to even less emptying of a mother's breast. We know that every drop of formula given is a drop less that your breast gets to make of breastmilk and, like mentioned above, nothing alerts the FIL gauge to kick in like an unemptied breast!