The amount of blood circulating to your breasts increases dramatically between the second and fourth postpartum day. Milk is released into the milk ducts generally between the third and fifth postpartum day. This is when engorgement may occur.
Engorgement is a process in which breast tissue swells and hardens. It lasts about 48 hours and causes varying degrees of discomfort. Some women feel only mild swelling and tenderness; others have more pronounced soreness as their breasts become firm and the skin stretches taut and shiny. To ease engorgement pain, you may use mild pain relievers between feedings and hot, moist packs or hot showers before feedings.
For the first few days after your baby is born, your breasts will secrete a thin yellowish fluid called colostrum. Composed of water, fat and protein, colostrum contains substances that can help your newborn's immune system. Although your milk doesn't "come in" for several days, don't worry about your baby not getting enough to eat. Colostrum contains all the nutrients a newborn needs. Nursing your baby on demand or at least every three to four hours acts as a good stimulus to milk production.
Wash your hands thoroughly before each feeding. Keep your breasts and nipples clean, but avoid harsh soap and drying lotions.
After several feedings, your nipples may become tender with the first few sucks as the baby latches on. This discomfort should be bearable and improve within the first few weeks of nursing.
If your nipples become sore or cracked, the baby is probably not latching on correctly. For breastfeeding help and guidance, you may call a lactation specialist at the Family Maternity Center where your baby was born. Other resources include your doctor, your baby's doctor, breastfeeding clinics and the Providence Health & Lifestyle Center. Phone numbers are listed inside the front cover of this booklet.
Simple treatments for sore nipples include the following:
- Exposing your breasts to air and keeping them as dry as possible.
- Wearing shells or nursing cups with a nursing bra.
- Placing wet tea bags on sore nipples.
- Covering sore nipples with a special dressing called viglon (tradenames: Second Skin, Water-jel), available over-the-counter at most pharmacies.
Watch for symptoms of a breast infection called mastitis. If you notice a red, tender area in your breast or if your temperature goes above 100.4 F, call your doctor immediately. Be sure to continue nursing or pumping your breasts, and remember—most medications, including birth control pills, enter breast milk. Ask your doctor before taking any medications while you're nursing.
If you choose to bottle feed your baby, you will want to dry up your milk supply as soon as possible. If your breasts become engorged, bind them with a tight bra and apply ice packs. You may express one to two ounces of milk every few days to relieve pressure in your breasts, but regular pumping will stimulate milk production and cause your breasts to remain engorged longer. You may also take Tylenol or ibuprofen to relieve breast discomfort, which usually lasts no more than 48 hours.