how to spot it and avoid it?

Its name leaves little doubt as to the situation: breast engorgement is the accumulation of milk, that is to say milk present in too much quantity in your breast (or sometimes in both breasts) and which cannot flow properly. This engorgement is more generally accompanied by edema which hinders the flow of milk. There is also talk of painful congestion of the breasts with edema. It is this congestion that blocks the circulation in the breast and increases the edema.

Let young mothers be reassured, this phenomenon is very common during the breastfeeding period, and it should in no way alarm you about your state of health, or the state of health of your baby, and you should come to recognize it more and more quickly.

What are the symptoms of breast engorgement?

And precisely, these symptoms, what are they? Because you may be experiencing breast pain, but you may not be able to identify it yet. “A engorgement affects the whole breast which becomes hot, red and very tense, painful”, explains Véronique Darmangeat, IBCLC certified lactation consultant and author of the book My breastfeeding bible. "This engorgement can affect one breast or both." Not to be confused with mastitis, which is an infection of the mammary gland, or blocked canals: "Mastitis or blocked canals affect only a part of the breast which can become hot, red, hard and painful", details the expert. "And these ailments usually affect only one breast, with some exceptions."

What can cause breast engorgement?

As you can imagine, the main cause of breast engorgement lies in the fact that the breast has not been sufficiently drained, that is to say that your baby did not drink enough compared to the amount of milk available in the breast. “We often find waterlogging when the milk rises”, says Véronique Darmangeat, “When the breast was not sufficiently drained during the first days, especially when there were long infusions during childbirth. But you can also get engorgement because your baby has skipped a feed, or slept longer than usual, for example. ”

If breast engorgement recurs and proves to be particularly important, we can also look for other causes behind this problem, which may hide a dysfunction in breastfeeding, as the Leche League explains to us. It can then be a physical difficulty in your child, with for example a tongue brake too short, a tongue too short or a weak suction, or a difficulty in you, in particular on the level of the nipple, with can -be a sore nipple or a nipple that is too big for your baby. Do not hesitate to ask your midwife or a lactation advisor for advice, who can also help you improve the quality of breastfeeding, such as better position during breastfeeding or better latching.

The association also highlights a study which showed that "Mothers with significant engorgement were much more likely to have smaller breasts than mothers with moderate engorgement (34% versus 12.5%)." Because if the size of the breasts has no influence on milk production, it can however have one on the capacity to store this milk. Women with small breasts may need to breastfeed more often.

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How to relieve breast engorgement?

If women were previously recommended to bandage their breasts to relieve the pain of engorgement of the breast, this is fortunately no longer the case today, and more effective and above all more comfortable methods for mothers are now recommended.
“The basic principle is to intervene as soon as possible”, advises Véronique Darmangeat. “You have to drain the breast as much as possible, either by feeding your baby often, or by using a breast pump. Milk is more difficult to flow than usual so the baby may be frustrated. Do not hesitate to make frequent small feedings. ”

Another treatment to relieve your hot breast that causes you so much pain: the application of cold compresses for about 20 minutes. These cold compresses will reduce the edema and improve the venous and lymphatic drainage of the breast.

The lactation expert also recommends the application of previously crumpled cabbage leaves on the breasts, since the cabbage has anti-inflammatory properties, while avoiding the areola. Then make sure to use organic cabbage leaves, change these poultices every two hours, and supplement with breast drainage to effectively relieve your breast engorgement.

“We can also use the technique called“ glass of hot water ””, completes Véronique Darmangeat. "We fill a glass with hot water, being careful not to put hot water, and we immerse the breast in the glass which will suck on the breast. In general, you can quickly see the milk flowing into the glass of water. ” Other sources of heat can also be effective in promoting this milk ejection reflex, such as applying warm compresses or simply a hot shower.

Another method to help the ejection reflex, that is to help the milk to flow from the breast and thus reduce pain: a massage of the areola, which will make it more flexible and reduce the breast tension. We can also recommend a lymphatic drainage, carried out by a professional, a specific massage which will make the edema disappear.

If the pain seems really too strong, you can obviously take a painkiller to relieve yourself. Just check that it is compatible with breastfeeding. And seek medical advice if you don't see improvement: “A waterlogging must get much better in 24 hours”, says the counselor. "If not, we can ask for help."

How to prevent the occurrence of breast engorgement?

Now that you have been able to diagnose and then provide effective treatment for the breast engorgement that has made you suffer, you would like to be able to minimize the risk of another incident and continue breastfeeding safely. You will have to be vigilant about your feelings, as recommended by Véronique Darmangeat. "As soon as you feel your breasts or breasts tighter than usual, you should not hesitate to put the baby immediately on the breast."

You will also need to ensure the good quality of your child's feeds. For the milk to flow sufficiently from the breast, no secret, it is of course necessary that baby find a good position for an ideal latch, and that he suckles effectively. Trust yourself: if you think your breastfeeding isn't going well, don't hesitate to ask for advice. Sometimes these are simple adjustments that will make all the difference.

It is also important, as the Leche League advises, to let your child finish breastfeeding one breast before offering the other. It’s up to him to decide when he’s had enough breast milk. The association also recommends a frequency of at least six feedings per day, with long feeds if possible, because a study has shown that very short and frequent feedings actually increase the risk of engorgement, by stimulating milk production without however drain the breast sufficiently.

"For the engorgement linked to the rise in milk", specifies Véronique Darmangeat, “The most effective will be to suckle your baby very often from birth. It is better never to exceed three hours between two feedings but it is preferable that the baby feeds more often than that. The easiest way to do this is to keep your baby on skin-to-skin or lightly clothed to allow easy access to the breast. As soon as the baby shows small signs of craziness, it is helped to latch on. A baby who sucks very often from birth learns to suck well on flexible breasts and effectively drains the breasts. We are therefore very lucky not to feel the rise in milk which can go unnoticed. ”

Also keep in mind that a mother who has used breastfeeding before will usually experience more engorgement, which will happen sooner after delivery but will also disappear more quickly. Similarly, a mother who has unfortunately experienced significant engorgement during a previous breastfeeding will be more likely to experience a new one with a new child if she chooses to breastfeed. So many reasons to improve prevention!

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