Especially in the early weeks of breastfeeding, you may experience swelling and tenderness of the breasts. As your milk comes in, your breasts will become engorged and full of milk, and it will take a little while for your body to regulate milk production so this doesn’t happen all the time.
Breastfeeding is supply and demand – the more your baby nurses, the more milk your body produces. In the first weeks, your body needs to figure out how much milk it needs to make in order to meet your baby’s needs. This process usually begins with a lot of milk being produced, but soon the production will settle down to the right level. In the meantime, there are some steps you can take to ease the discomfort.
The quickest way to relieve engorgement is to let the baby nurse. If baby is sleeping or not hungry, you can express a small amount of milk to take some of the pressure off, but use caution. Expressing too much will tell the body that the baby needs more, setting off higher levels of milk production and making the engorgement worse! The best way to express only a small amount of milk is to do it by hand, avoiding the breast pump. Try taking a warm shower and gently massaging the breasts until the milk lets down. Just the warm water and massage will ease the pain, even if no milk is released. However, if you can get a small amount of milk to come out this way, it will also take off some of the pressure.
Use warm compresses prior to nursing and cold compresses in between feedings to bring down the swelling. Using a cold compress prior to nursing will make it difficult for the milk to let down for baby. A great way to make a cold compress is to put some water in a newborn size diaper and put it in the freezer. Then, simply slip one into each side of your bra for soothing relief. Some women also use cabbage leaves as compresses to relieve engorgement.
Other Sources of Pain
Not all pain during nursing is caused by engorgement. Your nipples may become painful, red and crack or even bleed, especially as they get used to nursing. Lanolin ointments can help to relieve the dryness and cracking. Cold compresses will also help with pain. Make sure to gently clean nipples after nursing and allow them to dry before putting your bra back on to help prevent further problems.
Mastitis, a painful infection of the milk ducts, can occur anytime during breastfeeding, but is most common in the early months. It happens when a milk duct becomes clogged and it is not relieved quickly. Avoid mastitis by making sure to empty the breast completely, nursing baby on both sides equally, and dealing with any sign of a blocked duct quickly. If you notice a tender spot on the breast, a hard area where engorgement is not relieved in spite of nursing, or a general feeling of pain in the breast, you may have a blocked duct. Massage the area gently, apple heat, and allow the baby to nurse regularly to free the blockage. If you notice redness, swelling, or the pain does not go away within a few days, contact your doctor.
Some pain and discomfort during the early stages of breastfeeding is normal, and should resolve within a couple of months. With careful treatment and precautions, you can avoid most breastfeeding pain. However, don’t hesitate to call your doctor if you have continuing problems.