If a breastfeeding mother’s breasts become hard in the first few weeks or over the course of the breastfeeding period, breast engorgement may be present. This is shown by a hardened and hot as well as painful breast. Complaints such as fatigue, headaches and body aches or even fever can also occur.
What is engorgement?
If the breast does not completely empty during breastfeeding, then milk is left behind. This cannot drain, causing congestion in the milk ducts. Such engorgement is uncomfortable and can also cause pain. Breast engorgement usually occurs at the beginning of breastfeeding, when the mother’s breast produces a lot of milk due to the milk coming in. See AbbreviationFinder for abbreviations related to Engorgement.
This can from theinfantare usually not completely drunk. But even after a few months, breast engorgement can still occur. It is often enough if the baby oversleeps just one meal and the breasts begin to tighten. Hardening can then also be felt, which feels like a small warm knot. Breast engorgement should not be confused with the precursor to mastitis ( inflammation of the breast ), in which the tissue around the milk duct is swollen and presses on it, preventing milk flow.
Several glandular lobes make up the mammary gland. These glandular lobes consist of milk-forming sacs and a network of milk ducts. The milk flows from here to the nipple. Breast engorgement occurs when these milk ducts become blocked and cannot be completely emptied. There is an increase in pressure in the milk ducts, which is associated with tension and pain.
The causes of such a engorgement are very diverse. First of all, a missing milk ejection reflex can cause milk engorgement. Normally, the mother’s body releases the hormone oxytocin. As soon as the child suckles at the breast, the milk flows. However, physical exertion, stress or exhaustion can impair the milk ejection reflex and cause the milk to accumulate.
Excessive milk production can also be the cause. This produces more milk than the baby actually needs. An imbalance usually occurs when an infant suddenly sleeps through the night and no longer needs a nightly meal, or when a milk meal is replaced with porridge. The amount of milk increases, while the amount of drinking decreases. Normally, this regulates itself quickly.
However, the most classic cause of engorgement is usually mechanical disabilities. The reasons for this are incorrect attachment or incorrect sucking as well as too short and infrequent breastfeeding. The breast cannot be emptied completely. Sometimes a bra that is too small or clothing that is too tight can also block the flow of milk.
In addition, some women are more prone to breastfeeding problems, which then increases the risk of breast engorgement. This is the case, for example, with mothers of multiple births or with women who have had previous breast surgery.
Symptoms, Ailments & Signs
Breastfeeding occurs in many mothers. In most cases, this is the case shortly after birth, the breastfeeding relationship is still very new and the baby has not yet found the optimal sucking technique. The milk ducts are therefore not completely emptied.
Classic signs of breast engorgement are local pain in the breast, hardening and small palpable nodules in the breast or small, white blisters on the nipple. The breast is also excessively plump and warm to hot, and the nipples are very sensitive to touch. Furthermore, the skin on the breast may be red and the temperature may be slightly elevated, but general well-being is not affected.
If the engorgement remains untreated and the breast is still not completely emptied, a breast infection can be the result. Germs that multiply in accumulated breast milk are usually responsible for this. But even without germs, an infection can develop in the milk ducts . This happens when breast milk leaks into the surrounding tissues of the breast, causing inflammation. Breast inflammation caused by bacteria (e.g. Staphylococcus aureus) is accompanied by a fever of up to 40 degrees Celsius and causes flu-like symptoms.
Breast engorgement can cause sore nipples. Due to the sore nipples, germs from the baby’s mouth and throat can get into the breast through the sore spots due to stronger sucking, where the nipples become inflamed.
One problem with breast inflammation resulting from engorgement: the milk tastes different and it can sometimes happen that the baby stops drinking after just a few puffs or refuses the breast altogether. To avoid further pain, the breast should then be emptied by pumping.
When should you go to the doctor?
If the pain from breast engorgement gets worse or there is still no improvement after two days and the affected areas are swollen, warm and red, the breastfeeding mother should see a doctor. This is especially important when there is a deterioration in the general condition, headaches and body aches, fever and chills. In this case, a breast infection has already developed from the engorgement. Therefore, if you have symptoms: Better to see the doctor once too often to avoid such mastitis.
Breast engorgement is usually easy to diagnose based on a detailed medical history and physical examination. As part of the anamnesis, questions are asked about the symptoms. During the physical examination, the affected breast is palpated very carefully in order to cause the patient as little pain as possible.
The doctor will also ask about possible psychological stress in order to research a possible cause of the engorgement. During the diagnosis, it is also examined whether there are already signs of the development of breast inflammation. In this context, in the case of symptoms such as fever and chills immediately after delivery, further examination to rule out childbed fever makes sense, because this can be life-threatening if left untreated.
Treatment & Therapy
When treating breast engorgement, the “cooperation” of the affected patient is particularly important. In most cases, conservative treatment measures such as emptying the breast through regular breastfeeding or, if necessary, squeezing and pumping, the correct breastfeeding position, warming the breast before and cooling it (e.g. with quark wraps or cool pads) after breastfeeding, as well as plenty of rest and Relaxation is the most important treatment approach to treat breast engorgement.
In the past, nasal sprays containing oxytocin were also often recommended, which are said to help with milk drainage. However, such nasal sprays are no longer approved in Germany due to a lack of information on their safety.
In most cases, specific medical treatments are not necessary. However, if mastitis develops from the engorgement, the doctor will prescribe antibiotics. If milk congestion occurs during or shortly after weaning, weaning tablets are often helpful. In consultation with the doctor or midwife, breastfeeding-friendly painkillers can also be taken if the pain is unbearable.
Alternative treatment methods such as acupuncture, traditional Chinese medicine and the use of medicinal plants and herbs and essential oils can also be useful for breast engorgement. Homeopathic remedies such as globules can also be helpful without the milk being contaminated by chemical substances.
Outlook & Forecast
Overall, the prognosis for breast engorgement is very good. It is very easily treatable, with affected women having a number of options to choose from. However, the best chance of success with engorgement is pumping, although it should be noted that this in turn increases milk production. However, it brings the necessary relief to the breast and eliminates the engorgement for a while. However, it can recur at any time for many reasons.
For example, physical and psychological stress are important causes of breast engorgement. Accordingly, there are some women in whose lives engorgement is more common than others. Although frequent breast engorgement is also easily treatable, it carries a certain risk of developing breast inflammation or mastitis. Although such an inflammation can also be treated, it is very painful.
However, in almost all cases, breast emptying will eliminate engorgement. There is then no risk of consequential damage or any complications. Even with frequent engorgement, the breasts are not changed or become diseased if action is taken quickly. It is more important to take precautions so that breast engorgement occurs less frequently.
Breast engorgement cannot be completely prevented. However, by taking some preventive measures, the risk can be reduced. Breastfeeding mothers should always wear loose clothing that does not constrict. Especially after the birth, excess milk that the baby does not yet need should be pumped out or at least squeezed out until the supply and demand for milk are optimally matched.
If too much breast milk is produced or if the engorgement is already beginning, certain milk-promoting drinks should be avoided. Breastfeeding teas and herbal teas in particular should then be removed from the list of drinks. Sufficiently long recovery phases are also useful, because stress can also promote breast engorgement. The household and the care of the child should be left to the father.
Breast engorgement can reappear at any time after it has healed successfully, which is why it is important to check the flow of milk immediately afterwards. It is particularly important to ensure that the breast is emptied as much as possible. If the child has not drunk all of it, it can help to express the remaining milk to prevent it from building up again.
Follow-up care is therefore more focused on preventing breast infection. Once invading germs have settled in the accumulated breast milk and caused an infection, further complications can result.
It is important to normalize the changed drinking behavior of the child as quickly as possible. If this does not seem feasible, a switch to bottle feeding must be used as an alternative so that the child does not suffer from dehydration and nutrient deficiencies.
You can do that yourself
At the first sign of engorgement, breastfeeding mothers should contact their midwife or a lactation consultant. They have experience with such problems and can provide good assistance.
Of course, it is also important to continue breastfeeding. Contrary to what is often recommended, breastfeeding times should not be reduced or shortened. It is important that the breast is emptied, especially as a preventive measure or in the event of a blocked duct. Breastfeeding as needed and even when there are early signs of hunger is the motto. Since the problems usually start with sore nipples, changing the breastfeeding position can be helpful, because incorrect latching and breastfeeding techniques are often responsible for sore nipples. Sufficient hygiene should also be ensured.
Since germs can get into the open areas and cracks of sore nipples in particular, it is extremely important to wash your hands regularly before touching the breast. A warm full bath can also be helpful in the case of engorgement, because the heat causes the milk to flow almost by itself after about 30 to 40 minutes. The warm water also has a relaxing effect and helps to stimulate the milk ejection reflex.
Warm showers, compresses or cherry core pillows can also be helpful. Midwives and lactation consultants are also happy to show expectant mothers certain massage techniques that can be used to gently and gently express the milk.