Treatment of breast engorgement

It is important to treat breast engorgement early since delay in treatment leads to reduced in milk production and insufficient milk supply (1).

• ongoing support is important since it has been shown that breastfeeding rates decrease with a decrease in breastfeeding support
  • advice mother on correct position and attachment of the baby since effective suckling during feeding will improve milk removal and prevent nipple damage (2)
    
    
• advise the mother to breastfeed as frequently as the baby is willing
  • if the baby is unable to attach and suckle effectively, mother should relieve fullness and engorgement by expressing her milk by hand or with a breast pump
  • once the breast feels comfortable and the baby can attach better, advise the mother to breastfeed frequently (3)
    
    
• if the breasts are leaking - warm compresses to the breast or a warm shower before expressing will help in the milk flow (if the breasts are not leaking this should be avoided since it may aggravate swelling if the ducts are blocked) (1)
  
  
• use cold compresses or cold cabbage leaves after feeding or expressing may help in reducing the discomfort and oedema (4)
  
  
• breast massage and hand expression of breast milk - may help in the milk ejection process, increase milk supply and relieve blocked ducts (1)
  
  
• paracetamol and/or ibuprofen can be used for relief of pain (4)

Reference:

• 1. National Collaborating Centre for Primary Care (NCCPC) 2006. Postnatal care. Routine postnatal care of women and their babies
• 2. Mangesi L, Dowswell T. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev. 2010;(9):CD006946
• 3. World Health Organization (WHO) 2009. Infant and young child feeding. Model chapter for textbooks for medical students and allied health professionals
• 4. NHS Sheffield 2009. Section 1: Breastfeeding