These are all pretty good descriptions of what very milk-engorged breasts look like. But what do they feel like? And how long does it last? And does it happen to everyone?
During pregnancy your breasts get tender and achy. In fact, this is one of the very first signs of pregnancy. Around the time of birth, your body starts to produce a pre-milk substance called colostrum. It’s thicker and oozier and more golden-hued than actual milk. It comes in small doses, but it’s super potent: high-protein, low-fat, and crammed with immunoglobulins and antibodies. Some moms leak a little colostrum toward the end of pregnancy while others never see it (though it’s there). It doesn’t hurt when it comes in — it just appears one day. Colostrum is sometimes called “liquid gold”; it’s just what a baby needs for the first several days after birth.
Milk comes in within the first five days after birth. This is when a temporary period of “engorgement” tends to happen, though some women don’t have an uncomfortable period of engorgement at all. If you do get engorged, it can range from uncomfortable to downright agonizing. The milk ducts are suddenly loaded with milk and the breasts tend to look as I described above: hard, squared off, and/or lumpy. Mom’s body tends to make too much milk right at first and then after a few days the supply settles into about the right amount for a newborn.
If you have a painful engorgement period, try placing frozen cabbage leaves over the swollen breasts. You can also take ibuprofen and warm showers and use very soft, stretchy bras (no under-wires). Also, no matter what is going on with your milk, drink lots and lots of water. Your body is making and getting rid of fluids so often you need continual replenishment. (This will become obvious to you as you’ll find yourself very thirsty when nursing).
Now, every woman’s supply gets going and stabilized at different rates. This is *so important* to remember as that first week can be an anxious time for moms. On one end of the milk-making spectrum, there are those who are very concerned about not having enough supply (this is a common anxiety and often proven — much to mom’s relief — to be without foundation). On the other end of the spectrum, there are those who feel like they have triple-G cups (and may indeed have them; cup sizes do go up to H, J … you’d be amazed!) and are about to explode. Most women are somewhere in the middle.
If you are worried about supply coming in, talk to a lactation specialist, but mostly it’s a question of checking diapers for output; you’ll never see precisely how much a baby is getting but you can see what’s coming out the other side, and that can be reassuring.
If you have very painful,overly engorged breasts, they’ll likely go down all by themselves, and you’ll be relieved in a few days. Again, talk to a specialist if you’re worried — support in the beginning really makes such a difference. And keep an eye on possible repercussions such as plugged ducts (smaller, swollen, and very sore areas of the breast) or burst ducts, which can lead to an infection known as mastitis. Sometimes a small amount of massaging milk out and hand-expressing or pumping is necessary for women with severe engorgement. Letting a little milk out before a feeding can soften the breasts enough for the baby to get a good latch onto the areola. If your boobs are rock hard, the nipples flatten out, and the baby can have a hard time getting a hold. Now keep in mind that the initial period of engorgement typically lasts a few days and then settles, so really, though you may want to get some reassurance, this period of intense engorgement is normal and temporary.
No matter what level of engorgement you experience, the more frequently you feed the baby, the better. Sometimes known as “demand” feeding (feeding whenever the baby wants it), this tends to result in about 8-12 times a day. Don’t be worried about over feeding; you’re just getting the hang of this and the baby’s tummy is absolutely tiny, so frequent small milk meals are to be expected.
Every woman has a different experience with the milk coming in, so please chime in at the end if you’ve ever been engorged and you have some tips to offer expecting moms!
A great resource as you’re getting started is kellymom.com.
photo: Friendly Joe/Flickr