Beyond Cabbage Leaves – Causes and Solutions for Engorged Breasts

For nearly any woman who breastfeeds, at some point during her breastfeeding relationship, breast engorgement will happen. Engorged breasts happen when there is an overabundance of breast milk in the breasts, leaving them to feel full, heavy, and often painful. The most commonly shared piece of advice to treat engorged breasts is to line your bra with cabbage leaves, and while it sounds like an old wives' tale, this natural remedy can work to bring relief! But, there are other solutions, including (and perhaps most importantly) trying to identify the root cause of engorgement.

Cause: Poor latch. Solution: See a professional, fix your latch, empty your breasts! When your baby is latched on improperly, it often results in painful nipples and not enough milk being taken from your breast (which can also cause baby to eat more frequently and feel unsatisfied after a feeding). Over time (usually a short amount of time), this can cause breast engorgement. The most helpful solution is to have your latch assessed by a lactation consultant.

Cause: Not breastfeeding frequently enough to empty breasts. Solution: Feed or pump more often, or wait it out. Your breasts may become engorged if your baby suddenly changes her eating habits (sleeping longer), or if you experience a separation from your baby. Depending on your baby's age (it is advised that infants in the first few weeks while establishing healthy weight gain should not sleep through feedings), and your goals (do you want to maintain your supply, are you pumping during baby's separation), you may want to wake your baby to feed or use a breast pump to empty your breasts (and store the extra milk!). If, however, you're going through a change in your breastfeeding schedule, your breasts and milk supply will simply need time to adjust, during which engorgement is expected to happen.

Cause: Just because. Solution: Comfort and relief! Sometimes, despite your best efforts and successful breastfeeding relationship, your breasts will still become engorged. If this happens, and everything else is going well (no nipple pain, baby satisfied and gaining weight), it's a matter of keeping yourself comfortable and providing breast pain relief until the engorgement subsides and milk production regulates. Here are a few tips for comfort:

• Apply cold packs (avoid putting ice directly on your skin) before and after nursing to help reduce swelling and relieve pain.
• Wear a supportive nursing bra that is snug but not too tight and that does not have underwire.
• Hand express a little milk to relieve some of the pressure without fully emptying the breast to signal more milk production. Hand expressing a small amount before breastfeeding your baby also can help make it easier for baby to latch on when your breast is engorged.
• Gently massage your breasts while baby is feeding to encourage milk flow and emptying of the breast.

While engorged, it's important to be on the lookout for symptoms of mastitis, like fever and breast redness. See your care provider right away if you think you might have mastitis. Though it is uncomfortable and frustrating, breast engorgement, like most other stages and phases of new parenting, is temporary and will pass. Remember to breathe, hang in there, and seek support often!