Breastmilk usually "comes in" sometime during the first week after delivery. This means your milk changes from colostrum, or early milk, to mature milk. Your body may make more than your baby needs during this period and it is easy to become overly full.
It is normal for your breasts to become larger, heavier, and a little tender when they begin making milk. Sometimes, this fullness may turn into engorgement, when your breasts feel very hard and painful. Engorgement is the result of the milk building up. It usually happens during the third to fifth day after giving birth. But it can happen at any time, especially if you have an oversupply of milk or are not feeding your baby or expressing your milk often.
To prevent engorgement:
Start early, begin feeding soon after deliveryNurse frequently, about 8-12 times per day around the clockMake sure your baby latches-on well so he will empty your breasts effectively.Keep your baby actively nursing throughout the feedingDo not skip feedings or give formula feedings during the first several weeks.
Engorgement can also cause:
•Breast swelling
•Breast tenderness
•Flattening of the nipple
•Low-grade fever
Engorgement can lead to plugged ducts or a breast infection, so it is important to try to prevent it before this happens. If treated right, engorgement should fix itself.
What you can do:
•Breastfeed often after giving birth. As long as your baby is latched on and sucking well, allow your baby to feed for as long as he or she likes.
•Work with a lactation consultant to improve your baby's latch.
•Breastfeed often on the affected side to remove the milk, keep the milk moving freely, and prevent your breast from becoming overly full.
•Avoid using pacifiers or bottles to supplement feedings in the beginning. Try to wait to introduce pacifiers until your baby is 3 or 4 weeks old.
•Hand express or pump a little milk to soften the breast, areola, and nipple before breastfeeding.
•Massage the breast.
•Use cold compresses on your breast in between feedings to help ease the pain.
•If you are returning to work, try to pump your milk on the same schedule that your baby breastfed at home. Be sure to not let more than four hours pass between pumping sessions.
•Get enough rest, proper nutrition, and fluids.
•Wear a well-fitting, supportive bra that is not too tight.
•Try reverse pressure softening to make the areola soft around the base of the nipple and help your baby latch. Try one of the holds in the illustrations below. Press inward toward the chest wall and count slowly to 50. Use steady and firm pressure, but gentle enough to avoid pain. You may need to repeat each time you breastfeed for a few days.


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