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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

My daughter is 11 days old and suddenly I'm as engorged as I was the day my milk came in. Not only is it painful it is annoying. My baby cannot latch on properly so I am using a silicon nipple shield so she can eat. Should I continue to pump some out or does that just produce more milk? HELP!!

For some reason your breasts sound like they are not draining well, or perhaps the baby is not nursing frequently enough. It is difficult to answer without having you here to consult. However, it is fine to pump enough milk out that you can be comfortable. After your breasts soften from pumping some, perhaps your baby can latch and nurse well without the shield. In many cases, babies can latch deeper on the breast and help to empty the breast better without the shield.

You may also want to use some cold packs on your breasts between feeds to decrease the swelling. Some moms use big bags of frozen peas or corn all around the breast to help with this. You may also choose to use some gentle massage on your breasts as your baby nurses so that the milk will flow easier.

You did not mention how your baby is doing. I am hoping that she is getting plenty of milk despite the engorgement. Is she having 3-4 good-sized bowel movements and 6 good wets each day? At 11 days, she should be very close to, or surpassing her birth weight as well. Is she eating 8-12 times a day? Are you feeding at her cue? Do you hear her swallowing while she feeds? Does your breast feel much softer after she is finished and full? These are the things for you to look for as she feeds. Getting engorged again is a little unusual. Hopefully as she feeds better and better, you will not experience this discomfort again.

There are times that nipple shields can be helpful, but it is important that you keep close tabs to be sure your daughter is able to obtain adequate milk and keep your milk supply high. Hopefully you will be able to wean her off the shield very soon. One way is to begin the feeding with the shield, but part way through, unlatch the baby, take off the shield and see if she will nurse without it.

See the article Engorgement: You Can Avoid It for more information on preventing and treating engorgement.

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