Breast engorgement

Breast engorgement occurs in the

mammary glands due to expansion and
pressure exerted by the synthesis and
storage of breast milk. It is also a main
factor in altering the ability of the infant to
latch-on. Engorgement changes the shape
and curvature of the nipple region by
making the breast inflexible, flat, hard, and
swollen. The nipples on an engorged
breast are flat or inverted. Sometimes it
may lead to striae on nipples, mainly a
preceding symptom of septation
mastitis.[1]

Breast engorgement

Mature female breast engorged during

nursing phase

Engorgement usually happens when the

breasts switch from colostrum to mature
milk (often referred to as when the milk
"comes in"). However, engorgement can
also happen later if lactating women miss
several nursings and not enough milk is
expressed from the breasts. It can be
exacerbated by insufficient breastfeeding
and/or blocked milk ducts. When
engorged the breasts may swell, throb, and
cause mild to extreme pain.

Engorgement may lead to mastitis

(inflammation of the breast) and untreated
engorgement puts pressure on the milk
ducts, often causing a plugged duct. The
woman will often feel a lump in one part of
the breast, and the skin in that area may
be red and/or warm. If it continues
unchecked, the plugged duct can become
a breast infection, at which point she may
have a fever or flu-like symptoms.

Signs and symptoms

Symptoms include the breasts being
swollen and oedematous, and the skin
appearing shiny and diffusely red. Usually
the whole of both breasts are affected,
and they are painful. The woman may have
a fever that usually subsides in 24 hours.
The nipples may become stretched tight
and flat which makes it difficult for the
baby to attach and remove the milk. The
milk does not flow well.[2]
A fever may occur in 15 percent, but is
typically less than 39 degrees C and lasts
for less than one day.[3]

Causes
Failure to remove breast milk, especially in
the first few days after delivery when the
milk comes in and fills the breast, and at
the same time blood flow to the breasts
increases, causing congestion. The
common reasons why milk is not removed
adequately are delayed initiation of
breastfeeding, infrequent feeds, poor
attachment, ineffective suckling,[2] a
sudden change in breastfeeding routine,
suddenly stopping breastfeeding, or if a
baby suddenly starts breastfeeding less
than usual.[4]

Treatment
The mother must remove the breast milk.
If the baby can attach well and suckle,
then she should breastfeed as frequently
as the baby is willing. If the baby is not
able to attach and suckle effectively, she
should express her milk by hand or with a
pump a few times until the breasts are
softer, so that the baby can attach better,[5]
and then get them to breastfeed
frequently. She can apply warm
compresses to the breast or take a warm
shower before expressing, which helps the
milk to flow. She can use cold compresses
after feeding or expressing, which helps to
reduce the oedema. Engorgement occurs
less often in baby-friendly hospitals which
practise the Ten Steps and which help
mothers to start breastfeeding soon after
delivery.[2]

Regular breastfeeding can and should be

continued.[6] The treatment for breast
engorgement can be divided into non-
medical and medical methods. The non-
medical methods include hot/cold packs,
Gua-Sha (scraping therapy),[7] acupuncture
and drinking specialized herbal teas[8]
whereas medical methods are proteolytic
enzymes such as serrapeptase, protease,
and subcutaneous oxytocin. Cabbage
leaves are often cited as a possible
treatment but studies have found they
provide "no overall benefit" on breast
engorgement.[6] Evidence from published
clinical trials on the effectiveness of
treatment options is of weak quality and is
not strong enough to justify a clinical
recommendation.[6]

See also
Medicine
portal

Galactorrhea
Mammoplasia
References
1. Santos, Kamila Juliana da Silva; Santana,
Géssica Silva; Vieira, Tatiana de Oliveira;
Santos, Carlos Antônio de Souza Teles;
Giugliani, Elsa Regina Justo; Vieira, Graciete
Oliveira (2016). "Prevalence and factors
associated with cracked nipples in the first
month postpartum" (https://www.ncbi.nlm.
nih.gov/pmc/articles/PMC4975913) . BMC
Pregnancy and Childbirth. 16 (1): 209.
doi:10.1186/s12884-016-0999-4 (https://do
i.org/10.1186%2Fs12884-016-0999-4) .
ISSN 1471-2393 (https://www.worldcat.or
g/issn/1471-2393) . PMC 4975913 (https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC4
 975913) . PMID 27496088 (https://pubme
d.ncbi.nlm.nih.gov/27496088) .

2. "Management of breast conditions and

other breastfeeding difficulties" (https://ww
w.ncbi.nlm.nih.gov/books/NBK148955/) .
National Center for Biotechnology
Information US National Library of
Medicine. Retrieved 4 August 2017. This
article incorporates text from this source,
which is in the public domain.

3. "37". Williams obstetrics (24th ed.).

McGraw-Hill Professional. 2014.
pp. Chapter 37. ISBN 978-0-07-179893-8.

4. "What is Engorgement? What Causes It?" (h

ttp://www.webmd.com/parenting/baby/tc/
breast-engorgement-overview) .
5. "Warning Signs of Breastfeeding Problems"
(https://www.healthychildren.org/English/a
ges-stages/baby/breastfeeding/pages/War
ning-Signs-of-Breastfeeding-Problems.asp
x) . HealthyChildren.org. Retrieved
29 October 2020.

6. Zakarija-Grkovic, Irena; Stewart, Fiona (18

September 2020). "Treatments for breast
engorgement during lactation" (https://ww
w.ncbi.nlm.nih.gov/pmc/articles/PMC8094
412) . The Cochrane Database of
Systematic Reviews. 2020 (9): CD006946.
doi:10.1002/14651858.CD006946.pub4 (htt
ps://doi.org/10.1002%2F14651858.CD0069
46.pub4) . ISSN 1469-493X (https://www.w
orldcat.org/issn/1469-493X) .
PMC 8094412 (https://www.ncbi.nlm.nih.g
 ov/pmc/articles/PMC8094412) .
PMID 32944940 (https://pubmed.ncbi.nlm.
nih.gov/32944940) .

7. Chiu, Jin-Yu; Gau, Meei-Ling; Kuo, Shu-Yu;

Chang, Yung-Hsien; Kuo, Su-Chen; Tu, Hui-
Chuan (March 2010). "Effects of Gua-Sha
Therapy on Breast Engorgement: A
Randomized Controlled Trial" (https://doi.or
g/10.1097%2FJNR.0b013e3181ce4f8e) .
Journal of Nursing Research. 18 (1): 1–10.
doi:10.1097/JNR.0b013e3181ce4f8e (http
s://doi.org/10.1097%2FJNR.0b013e3181ce
4f8e) . ISSN 1682-3141 (https://www.world
cat.org/issn/1682-3141) . PMID 20220605
(https://pubmed.ncbi.nlm.nih.gov/2022060
5) . S2CID 18329014 (https://api.semantics
cholar.org/CorpusID:18329014) .
 8. "Tackling engorgement and mastitis: an all-
in-one guide" (https://www.meandqi.com/jo
urnal/engorgement-and-mastitis-complete-
guide) . www.meandqi.com. Retrieved
26 March 2019.

External links
Breast Engorgement (https://web.archiv
e.org/web/20081019232110/http://ww
w.breastfeedingchild.com/breast-engor
gement.html)

Retrieved from
"https://en.wikipedia.org/w/index.php?
title=Breast_engorgement&oldid=1136284222"
This page was last edited on 29 January 2023, at
16:47 (UTC). •
Content is available under CC BY-SA 3.0 unless
otherwise noted.