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Too Much Milk
How to Avoid Engorgement
By Melissa Clark Vickers, IBCLC
In one sense, engorgement is part of a very normal process that prepares a new mother to breastfeed her infant. The breasts enlarge with mature milk and other fluids, typically within the first three to five days after birth. Up until this time, the breasts have colostrum, a highly-concentrated first milk. This "liquid gold" is perfect for the newborn's tiny stomach and digestive system as he learns to milk the breast effectively.
When he is ready to handle larger meals, the breasts are ready with more milk. Eventually, the breasts will settle into a pattern of making milk based on the infant's needs, as judged by how much he takes from them.
When the mature milk comes in, generally there is no mistaking that it has arrived! The breasts are noticeably larger and feel "full." There generally is no pain associated with this fullness, and while it may feel different – especially to the first-time mom – it doesn't prevent a baby from nursing well. This fullness is completely normal and technically isn't considered "clinical engorgement."
Clinical engorgement is a serious condition in which the breasts become so full that they feel like rocks. The swelling may extend well into the armpits and upward toward the neck. The breasts are typically hot to the touch and painful and interfere with a baby's nursing.
Remember that in order to effectively nurse the breast, Baby has to be able to compress the areola, the dark area surrounding the nipple. With true engorgement, Baby can't get onto the breast far enough to milk the sinuses below the areola. It is a little like trying to nurse a basketball!
Unfortunately, when that milk is not effectively removed, initially more milk will be added to these already distended breasts. If the condition isn't treated, the breasts will take this as a signal to cut back on milk production. Obviously, this is a condition to be avoided when possible and treated quickly if it does happen!
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Re: Too Much Milk by mary on 10/23/2008 01:14PM
I just pump the milk, and iI am trying to quit, but I get so full, and I have had mastitis three times already, so I'm scared of getting too full. How can I do it without getting infection again?
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How to Avoid Engorgement by Mother of eight on 09/16/2009 10:04PM
I had engorgement particularly with my first 3 daughters. They were sleepy babies even though I had no medications or interventions of any kind. There was too much milk. I hand expressed enough milk so they could latch but they would get full and it didn't feel like hardly any milk was taken out! Never mind the other breast would fill up more!! I was awful for three days ; I was swollen up to my neck; couldn't sleep and had to take pain medications.. When I had my first boy at number 4 pregnancy; he ate more and was more alert so I didn't get engorged. I think it is 1. that I had smaller sized breasts that had too much milk, and 2. my girls weren't big eaters. Twins run in my family ( 2 sets in mine!). any relationship, hmmm. The best thing to do (in retrospect) is to buy or rent a hospital quality pump and GET THE MILK OUT. I suffered much too much and listened to my mother in law who said oh, it's not milk it's just swelling. Don't pump, you will just make too much milk. Ah!!! Bad advice. I know better now after all the kids!!! I can help my own daughters.