Your mature breast milk will ‘come in’ a few days after giving birth. Up until then, you will be feeding your baby with colostrum. The milk that comes in at every feed includes both foremilk and hindmilk, and the volume of milk that you produce will increase considerably.

This can result in what is called primary engorgement, where the breasts become full, tender and lumpy, often with flattened nipples which are hard for the baby to grasp.

A certain amount of fullness is inevitable: your breasts are accommodating a large amount of milk, and there is extra activity in the blood vessels and lymph glands to prepare them for producing milk. However, you can take steps to prevent or minimise discomfort.

You may experience engorgement during the first few weeks, when your baby hasn’t settled into a pattern of feeding. The worst should be over in about two weeks and, by four to six weeks, your milk should be established and your body will have adjusted to the changes.

You may find that you experience engorgement again (this time called secondary engorgement) when your baby first sleeps through the night, or misses a feed for some reason. Your body will quickly adjust, but you should use the remedies for primary engorgement to relieve any fullness. Remember that feeding your baby is the best way to relieve engorgement.

It is important to relieve the symptoms of engorgement to prevent mastitis from developing.

Remedies

• Offer unrestricted feeds after birth
• Make sure your baby is well positioned at the breast

If you become engorged, try one or more of the following:

• Express milk before the feed to make it easier for your baby to latch on
• Put something cold on your nipple to make it more erect so that the baby can latch on
• Use a warm compress before feeding to help the milk flow
• Offer your baby frequent feeds
• Express milk after a feed if your baby has not fed enough to soften the breast

• Take a warm bath or shower to help relieve full breasts. If you gently massage your breasts in the bath, you should find that you can express some milk away, which will soften your breasts

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