Breast engorgement

Symptoms include the breasts being swollen and oedematous, and the skin appearing shiny and diffusely red. Usually, the whole of both breasts is 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. A fever may occur in 15 percent, but is typically less than 39 degrees C and lasts for less than one day. == 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, == 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, 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 that practise the Ten Steps and help mothers to start breastfeeding soon after delivery. Medical methods of treating engorged breasts 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. and help mothers begin breastfeeding soon after birth. == See also ==