When you are breastfeeding, there are a number of things that you may experience with your breasts. One of it is breast engorgement.
Engorgement or swelling of your breast is a common issue faced by many mothers and it is totally normal to experience it.
Photo created by freepic.diller
What Is Breast Engorgement?
Breast engorgement is when your breasts are full of milk. Imagine your breast as a balloon but without the elasticity and fragility. Fill the balloon with water and you can start seeing it becoming more and more tighten, compact, and heavy.
Similarly, your breast will become compact, and heavy when it is filled with milk.
When at last it reaches a point where it is starting to exceed its capacity, it will begin to engorge or in other words, to swell (membengkak)
Symptoms.
There are several symptoms of engorgement that you can observe on your breast.
1. Your breast feels warm and heavy.
2. Your breast is firm and painful.
3. The areola part of your nipple feels hard and your nipple is flattened.
4. Swollen and tender up to the underarm area.
5. Body temperature rise slightly to 38 degree Celsius
When Does Breast Engorgement Happens?
Breast Engorgement During Pregnancy
Your breast may be engorged even before your baby is born. So, don’t be alarmed when you start to feel heaviness, tenderness and swelling in your breast during pregnancy.
It is quite normal and happens more commonly during the later halves of your pregnancy.
This is because some mothers may have active milk ducts that starts to produce milk way before delivery takes place. This is a natural process done by the body as they prepare to welcome your child.
The milk produce during pregnancy may leak too but it is best not to pump the breast because that may encourage the breast to produce more milk.
Postpartum Breast Engorgement
Engorgement can happen after delivery too. It is very common to experience this during the first week after delivery because as soon as your baby was born, your prolactin hormones are activated.
Note: Prolactin hormones are the hormones that are responsible to signal your body to make milk.
You can relieve the engorgement by breastfeeding your baby or pumping the milk.
If you don’t know how, you can seek help from the lactation consultant who will teach you how to breastfeed your newborn child.
How Long Does Engorgement Lasts?
The length of time a breast would stay engorged will differ from person to person but at average, it usually lasts about two to three days.
After a week, your breasts will start to adjust the milk production to your baby’s demand and timing.
Is Breast Engorgement Dangerous?
If your breast still swells and harden after a week, consult your doctor. Especially if the engorgement does not seem to subside and you are starting to feel feverish. It could be a sign of Mastitis or other breast infections.
When your condition becomes severe, it can also impact your child. The engorgement of your breast causes your breast to become hard and tight. As a result, your baby will face difficulties to latch on the breast for breastfeeding.
This may cause your baby to be underfed.
It is more of a concern when it comes to newborn baby not just because the breastmilk has high nutritional value that would benefit your baby most during this time but also because your baby may not have much alternatives compared to their older counterparts.
Not attending to the engorgement in your breasts can be painful for you but it also can make your nipple cracked and sore which will make it harder for your baby to latch on for breastfeeding.
So, consult your doctor if your symptom prolongs and get it treated quickly.
What Causes This?
Since engorgement is a case of your breast producing milk over the capacity, the main causes of this condition are often connected to failure of getting the milk out or emptying your breast. These includes:
Skipping or missing a pumping or breastfeeding session
When you skip or miss a pumping session or a breastfeeding session, you are not emptying your breast in time. During this time, your breast will keep producing milk, thus causing your breast to become engorged.
Your baby is not well
The health condition of your baby can also be a factor. When your baby is unwell, they would usually feed less hence your breast is not properly emptied which leads to it exceeding capacity.
Your baby have a hard time latching or sucking during breastfeed
Another factor for engorgement is when your baby is not latching or sucking the milk properly.
Similar to the previous, this will cause your breast not be emptied properly and will cause it to be full quicker.
When breastfeeding your child, make sure your baby is sucking the milk in instead of air.
Planning not to breastfeed
Pediatricians around the world advocate for mothers to breastfeed their child for more health benefits but the choice is still yours.
However, we do understand that some health condition may cause the mother to choose not to breastfeed.
If you are planning not to breastfeed, you may experience your breast being engorged for a few days before it subside.
The trick is to not encourage your breast to produce more milk by expressing, pumping, or stimulating it by any way.
Baby is weaned too quick
Your breast’s milk production replies to your baby’s demand. When it is time to wean your baby off of breastmilk, you may want to take it a little slowly.
You can try by gradually reducing feeding time so your breast can adjust to the demand and schedule. Stopping breastfeeding immediately and suddenly may cause you to experience breast engorgement.
Other causes may come from your breasts’ condition such as oversupplying or overproducing breastmilk which is more than what your baby needs.
Using formula milk in between nursing session can also cause engorgement because your baby may suck less than what your breast produce.
Breast Engorgement Prevention
Preventing your breast from getting engorge can be easy. The key is to make sure that your breast is empty at a regular. If you are unable to breastfeed your child on a timely basis, you can always pump and store the breastmilk for later.
If you notice that your breast are producing more milk than your baby needs, you can chill your breasts with ice/ice packs.
Cooling down your breast stops the signal to your breast that tells them to make more milk. As opposed to this, you can use warm towel to promote milk production.
If you feel that the pressure in your breast are too much to handle but you do not want to breastfeed or pump, you can use hand expression or pump in small amount to relieve the milk.
However, make note not to over-pump because pumping too much can cause your milk to produce more milk.
Breast Engorgement Management
1. Home remedies
You can use cold compress to slow down milk production or do regular pumping and breastfeeding to reduce the milk in your breast. You can also try putting cold cabbage leaves on your breast to relieve it.
2. Ointment
There are creams available in the market that can help with cracked nipple. Some creams are made to help mothers during the weaning period which helps to reduce the milk production.
We recommend reading the ingredients and get advise from your doctor about the cream or ointments before applying.
3. Tools
Engorgement can be relieved in two ways which is hot and cold. You can try using thermal pads that can do cold and warm relieves to help reducing breast inflammation or to promote easy let down.

Mastitis vs Engorgement
Mastitis is a condition where your breast tissues and milk ducts are inflamed causing breastfeeding to be a painful experience.
Mothers often confuse between engorgement and mastitis because the symptoms are almost similar especially the condition of your breast.
The difference is that mastitis will make you feel shots of pain when you are breastfeeding your child or pumping contrary to engorgement which would be relieved with breastfeeding and pumping.
You would also be experiencing fever and flu-like symptom like fatigue and headaches. Mastitis are mainly caused by blocked milk ducts or cracked nipples. Untreated engorgement condition can lead to Mastitis.
Reference: https://www.mydr.com.au/babies-pregnancy/engorgement-and-mastitis/
Does Cold Cabbage Leaves Really Helps?

Cabbage photo created by www.slon.pics
If you have read somewhere in the internet or if someone has suggested it to you about putting cabbage leaves on your breast to reduce engorgement, then you are not alone.
However, we cannot exactly say that it would help because there is not enough research in this area.
A plausible reasoning behind this tip is perhaps the coldness of the cabbage leaves can help cool the inflammation of your breast.
Nonetheless, there is no harm to try. It may work for some women but for some it may not make much of a difference.
Reference: https://www.wongbb.com/use-of-cabbage-leaves-and-cold-gel-packs-to-reduce-breast-engorgement/