How Do I Relieve Engorgement?

Relieving engorgement can make a new mom’s day.
I always tell my clients who believe they have low breast milk supply that the grass is always greener, and oversupply of breast milk is not fun either.
Oversupply can lead to plugged ducts, mastitis, chronic engorgement, and pain. In addition, her infant may experience gas, green frothy stools, fussiness, and breastfeeding issues related to an overactive let down.
Engorgement can negatively a mother’s mood at home, or her ability to concentrate at work. It can also lead to medical interventions, like antibiotics for mastitis. For some women the consequences of oversupply take several days to manifest, but this is not the case for all women. I have a friend who did not pump before bed one night, and she woke up with mastitis and was sick in bed the next couple of days.
What can you do to relieve engorgement and reduce pain? Here are 5 suggestions.
There are a few things you can do to relieve engorgement and reduce pain.
1. Learn breast massage and hand expression.
Breast massage can help to open the vessels within the breast and move the milk around. Hand massage can help to remove the milk and relieve the pressure that causes pain.
Below is one of my favorite videos by Maya Bolman, posted here with her permission. I like how it explains both techniques well.


The Basics of Breast Massage and Hand Expression from Maya Bolman on Vimeo.

2. Women that are not comfortable with hand massage can also use their breast pump for a few minutes to relive pressure before feeding.
This will help increase their comfort, and also make feeding more enjoyable you’re your infant, which may increase duration and quality of the feeding.
How does this work? The infant will have the ability to take more breast tissue into his mouth and form a deep latch. Also, because the let down will have already happened it decreases the initial workload for the infant. The infant can form deep latch and begin removing milk as soon as he latches, with plenty of energy to remove a lot of milk.
3. Use heat to open the vessels for milk to be removed effectively.
I have been known to stand at client’s side for an hour while slowly massaging her breasts while she pumps, while her partner runs back and forth from the sink with warm moist washcloths. After an hour of this practice, we removed a significant amount of milk, and mom began to smile and appeared more comfortable. Removing milk in a warm shower may relieve discomfort and reduce tension within the breast.
4. Women have been using cabbage through the ages for severe, persistent engorgement.
To effectively use cabbage, roll a rolling pin over the veins to break them down and increase the flexibility of the leaf. Put the leaves in your bra and leave them there until they whither. Repeat if necessary.
Warning: This is extremely effective and quick, but can also affect your supply. I usually suggest to my clients they only do this once every 12 hours, so they do not reduce breast milk production when they are relieving engorgement.
5. Call an International Board Certified Lactation Consultant (IBCLC)!
An IBCLC can look at several issues that can be causing your engorgement such as the way you are pumping, the fit of your breast pump phalanges, your infant’s ability to remove milk, and your overall breastfeeding pattern.
All of the above issues may reduce the removal of milk from the breast. However, if your breast has not yet slowed the production of the milk, you may experience engorgement and pain.
Breast milk is produced based on supply and demand; if the breast perceives you need more milk for the baby, then it will make more milk. If it perceives you do not need as much, it will begin to reduce production; however the time period between that actual reduction of milk and removal is when many women experience issues with engorgement.
Understanding how the breast perceives breast milk production and how to effectively remove it in a timely manner can lead to a wonderful relationship with your growing baby and satisfaction with breastfeeding. Constant pain from engorgement, or a shallow latch can impact the relationship for both you and your baby.