 ENGORGEMENT
Most of us have been there, breasts that look like swollen melons, painful and sometimes itchy…….We wonder what has happened to our breasts! Will they ever go back to normal? Engorgement is a common and treatable problem, recognising the signs and treating it early is key. For most mothers their milk usually comes in 2-5 days post partum. As this occurs the breasts normally become full and the areolar remain soft. The fullness usually lasts for approx. 24 hrs, the milk should flow normally and the baby should be able to latch on without difficulty. Signs of Engorgement: Engorgement can develop anywhere from the 3rd-5th day post birth and with appropriate treatment it should subside within 12-24 hours. The skin on the breasts may look tight and shiny, the breasts may appear swollen. Often mothers feel very full and uncomfortable, they may also have a throbbing sensation in the breasts. The breasts will feel hard and sometimes lumpy. Engorgement may occur in both breasts but it can arise in only one or sometimes in the areolar. Causes of Engorgement:
Tips to Relieve Engorgement: Massage is an excellent way to relieve engorgement, it’s very important that it is gentle and light. Causing pain while massaging hard will inhibit let down and effect milk flow. Lying down on your back and massaging towards the armpit can encourage the excess fluid in the breasts to drain back towards the lymph nodes under the arm this can be done before or after feeding. Cold compresses or clean cabbage leaves are very soothing and help to reduce inflammation in the breasts. Applying cold both before and after feeds is extremely helpful. Wet face cloths kept in the fridge or frozen peas wrapped in a towel are really useful. Heat is not advisable as it will increase inflammation. Frequent feeding is so important for relieving engorgement, keeping your baby close where possible, feeding on demand and watching for early hunger cues. Always establish a good latch as this allows the baby to effectively drain the breasts. If your breasts remain full and engorged after feeding hand expression can be very helpful, gentle massage prior to hand expressing aids with the let down. Only express to comfort and you can store and keep any milk obtained. Maya Bolman has a wonderful video on hand expression and breast massage. Here is the link https://bfmedneo.com/our-services/breast-massage/ If the areolar is engorged and taut it can be very difficult for your baby to latch on to the breast, in this situation Reverse Pressure Softening can be used. Here is the link to Jean Cottermans handout on reverse pressure softening http://www.health-e-learning.com/articles/RPS_JCotterman_ver2005.htm Finally if your symptoms worsen ,you are feeling unwell or have any concerns about mastitis contact your IBCLC, PHN or GP. Further Resources: https://kellymom.com/bf/concerns/mother/engorgement/ https://breastfeeding.support/engorged-breasts/ https://www.laleche.org.uk/engorged-breasts-avoiding-and-treating/
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 Partners role in the breastfeeding experience........How can Dads help with breastfeeding?
Supporting your partner’s decision to breastfeed and giving her lots of encouragement especially in the early days is so important. Research has shown women are more likely to keep breastfeeding if they have a supportive partner. Breastfeeding is the normal way to feed your baby, but it is still a skill which needs to be learned by mum and baby. Dads support during this steep learning curve is paramount. What can Dads do? Go to a breastfeeding class, many couples feel that these are for the mums only but it is really helpful for expectant Dads to learn about breastfeeding. The information in these classes will prepare Dads for some of the challenges that they might be faced with. Dads are often the ones to remember more of the information, particularly in the early days. After the baby is born new mums can be overwhelmed with exhaustion. Visitors can add to this therefore its Dads job to keep the visitors at bay! Try to ensure that there is quiet time and time for sleep. While the visitors are there watch for the babies feeding cues and if your partner is not comfortable feeding in front of them ask them to leave. Tending to household chores, keeping washing underway and shopping is very helpful; this allows your partner to focus on the baby. Also ensuring that there is healthy nutritious food ready for whenever she needs it. If she is having any difficulties listen and support her. Be sure to know where to get help, and encourage her to do so. There are lots of breastfeeding support groups out there. How can Dads bond with their baby? Wear your baby in a sling, take them for a short walk to give your partner a rest, or just rock them in it. Dads can do skin to skin too, enjoy your new baby by lying him on your chest and reading to him or just soak him all up! Changing your baby’s nappy is a great way to bond with him, in the early days newborns tend to cry alot during nappy change, but this soon changes and it becomes a big game for everyone involved. Bathing your baby is a wonderful thing to share with him, after a few weeks you can bathe together and this is always a special way to bond with your baby. Soothing cuddling and winding your baby after or between feeds gives your partner a break and allows for more cuddles from Dad. Your new baby has so many needs, feeding is only one of them. Bonding comes from special time spent together from the beginning. Remember to praise your partner and the wonderful job she is doing, giving your baby the best possible start in life. Book a consultation  Newborns: A simple guide to get you through the first few weeks Breastfeeding in the early days is such a special and important time for both you and your baby. But it can also be a time of worry. It helps to remember that all babies are programmed to breastfeed and with a little bit of guidance most will comfortably and easily find their way to the breast. When your baby is born try to avoid separation where possible, sometimes in a hospital setting it is difficult but you can ask your midwife to put your baby skin to skin after he is born. The WHO recommends at least 1 hour of uninterrupted skin to skin immediately after birth. Skin to skin has multiple benefits for you and your baby. It calms and relaxes both you and your baby, it regulates your baby’s heart rate, temperature and breathing, its stimulates his digestion and his feeding behaviour and protects him from infection by allowing friendly bacteria from your skin to colonise his. Skin to skin goes way beyond the delivery room, it is something that can be used throughout your breastfeeding experience, and is especially helpful in the early days to stimulate a sleepy baby to feed. Newborn babies need very frequent feedings. There are few reasons for this; firstly they have very small tummies.
Recognising your baby’s feeding cues is very helpful for your breastfeeding experience, crying is a late feeding cue. Trying to latch a crying baby can be difficult; therefore trying to offer the breast when your baby is calm is always helpful. Early Feeding Cues:
When latching your baby to the breast try and ensure a deep latch. This will prevent sore nipples and help your baby to transfer milk effectively. Breastfeeding should not be painful, some mothers will feel some discomfort when their baby latches initially but if this pain continues for 30 seconds or more you should take your baby off and relatch him. There is no time limit on each feed, let your baby decide how long he wants to feed on each breast. Every baby is different, some will always feed from both breasts and others will feed from one. You will soon get to know your own baby’s needs. It is normal for newborns to cluster feed in the evening anytime from 6 or 7pm. Sometimes if you are prepared for this it can make things easier. Most new mums are concerned if their baby is getting enough milk. Usually what goes in must come out! Therefore your baby’s wet and dirty nappies are a good indicator of milk transfer. By about day 5-6 you should expect 3-4 yellow seedy poos and 6 wet nappies. If you are concerned about your baby’s needs ask for help, you can contact your PHN, La Leche League, Cuidiu or an IBCLC. Nightime feeds are always a challenge, but are very important for your baby’s growing needs and your milk supply. Night feeding is very normal newborn behaviour, keeping your baby close can make it easier. Breastfeeding is the normal way to feed your baby, its convenient free and easy, but always remember to ask for help, Good luck. Book a consultation
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