Prevention
The following recommendations are useful for the prevention of breast engorgement:
. start nursing as soon as possible;
. breastfeed on demand;
. use a proper breastfeeding technique;
. avoid the use of supplements.
Treatment
Once breast engorgement is established, the following measures are recommended:3
. if the areola is engorged, manually express some milk before breastfeeding, so that the areola gets soft enough for the baby to grasp it properly;
. breastfeed on demand on a regular basis;
. massage the breasts gently . this is important to fluidify the viscous milk and to stimulate the let-down reflex;
. use systemic analgesics/anti-inflammatory drugs. Ibuprofen is regarded as most efficient, and it also helps to reduce inflammation and edema. Paracetamol can be used as an alternative;4
. wear a well-fitting, supportive bra with large flaps for pain relief and in order to keep the ducts in an anatomical position;
. apply warm compresses to help the ejection of the milk;
. apply cold compresses after or between breastfeeding to reduce edema, vascularization and pain.
If the baby is not sucking, the milk must be manually expressed or pumped. The emptying of the breast is essential for maternal relief, to reduce mechanical pressure on the alveoli, remove the hindrance to the drainage of the lymphatic system and edema, minimize the risk of insufficient milk production and, especially, the risk of
mastitis.