Operation Lactation

I worked with this great nurse practitioner who would check-in on momma's on the mother-baby unit, and she provided some extra special instructions for home care. My favorite piece of advice began: "If you wake up feeling like Dolly Parton..." and she did not mean, "if you wake up feeling like a country music legend", although that would be pretty super. She was, in fact, referring to Dolly's impressive chest. Unfortunately, if you are feeling like Dolly Parton in the postpartum period it does not mean you are feeling glamorous, it means that you are engorged.

Engorgement is a side effect of increased milk production and usually occurs between days 3 to 5 after delivery. The first couple days after birth, your breasts are producing colostrum, which is basically concentrated breast milk with less fluid volume. As baby nurses frequently and on demand, your body will begin to produce more milk. On day 5, at the very latest, breast milk should be in full production (no more colostrum), and this sudden transition is what causes you to feel like Dolly Parton. The good news is that this is a passing phase and usually your body will self-regulate within 24 hours, plus engorgement is a sign that your hard work is paying off and your milk is coming in!

There are some easy things you can do at home to make yourself more comfortable. Ibuprofen is an anti-inflammatory medication that can ease your discomfort and it also can decrease swelling. It is safe to take while breastfeeding, and there is a good chance that your doctor prescribed it to you for your post-delivery aches and pains. Cold can be soothing after a breastfeeding session. Apply cold washcloths or ice packs to your breasts after baby finishes nursing. Likewise, AVOID heat on your breasts because it will cause more inflammation and exacerbate the problem. So when showering, do not put the girls right under that hot water, and keep them away from heating pads. Also, be mindful of your bra choice. It will not help to wear a bra that is too tight or is pinching in areas. The absolute best thing to do is to get that milk out of there! So put that growing baby to work and if baby does not cut it, Milk it! yourself by hand expressing or pumping. In extreme situations, you may find that baby cannot latch onto your tight and full breast so you will need to express enough milk so that your breast is softer and "latchable". Your goal is to keep that milk flowing to keep yourself comfortable.

Engorgement is not guaranteed. Not ever momma experiences this over-full feeling, and if you are one of those lucky ones, keep doing what you are doing. The best engorgement prevention is frequent emptying of your breasts. This is another reason why it is important to let baby nurse on-demand and at least 8-10 times in a 24 hour period.

Hang in there! This is a passing phase that time will fix.

Peace, joy and blessings!