Breast engorgement


Breast engorgement

Description, Causes and Risk Factors:

Breast engorgement is the painful overfilling of the breasts with milk. This is usually caused by an imbalance between milk supply and infant demand. This condition is a common reason that mothers stop breast-feeding sooner than they had planned.

Breast engorgement can also occur due to four main factors such as a suddenly increased milk production that is common during the first days after the baby is delivered or when the baby suddenly stops breastfeeding either because it is starting to eat solid foods or it is ill and has a poor appetite.

After the first 3 to 4 postpartum days, the quantity of colostrum (milky fluid secreted for the first day or two after parturition) is quickly replaced by an increased milk production. When milk production increases rapidly, the volume of milk in the breast can exceed the capacity of the alveoli to store it and if the milk is not removed, the alveoli become over-distended which can lead to the rupture of the milk-secreting cells.

Breast engorgement

Accumulation of milk and the resulting engorgement are a major trigger of apoptosis, or programmed cell death, that causes involution of the milk-secreting gland, milk resorption, collapse of the alveolar structures, and the cessation of milk production.

Severe breast engorgement can lead to the flattening of the nipples or, it can result in inverted nipples which make it impossible for the baby to suck out all the milk from the breast. This is one of the common causes of the stagnation of milk in the breast.

Not all women experience breast engorgement after they give birth and some degree of engorgement of the breast is however normal within the few postpartum days. Women with mild-to-moderate hypoplastic breasts with a wide intramammary space (>1 inch) and a tubular shape are at particular risk for producing less than 50 percent of the milk necessary for the first week.

Symptoms:

    Engorged breasts are swollen, firm, and painful. If severely engorged, they are very swollen, hard, shiny, warm, and slightly lumpy to the touch.

  • May have flattened-out nipples. The dark area around the nipple, called the areola, may be very hard. This makes it difficult for your baby to latch on.

  • Can cause a slight fever of around 100°F (37.8°C).

  • Can cause slightly swollen and tender lymph nodes in your armpits.

Diagnosis:

No exams or tests are needed to diagnose breast engorgement. If your doctor suspects a breast infection (mastitis), you will be treated with antibiotics.Sometimes a sample of breast milk is tested (cultured) to diagnose the type of bacterial infection.

Treatment:

A few days after your milk comes in, your milk supply should adjust to your baby's needs. You can expect relief from the first normal engorgement within 12 to 24 hours (or in 1 to 5 days if you are not breast-feeding). Your symptoms should disappear within a few days. If not, or if your breasts do not soften after a feeding, start home treatment right away.

To reduce pain and swelling, take ibuprofen (such as Motrin or Advil), apply ice or cold compresses, and wear a supportive nursing bra that is not too tight.

To soften your breasts before feedings, apply heat, massage gently, massage gently, and use your hands or a pump to let out (express) a small amount of milk from both breasts.

If your baby cannot feed well or at all (such as during an illness), be sure to gently pump enough to empty each breast. You can store or freeze the breast milk for later use.

If your breasts still feel uncomfortable after nursing, apply cool compresses.

If you are not breast-feeding, avoid stimulating the nipples or warming the breasts. Instead, apply cold packs, use medicine for pain and inflammation, and wear a supportive bra that fits well.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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