Seeking Advice About Engorgement

Updated on May 06, 2007
S.S. asks from Jefferson City, MO
16 answers

I had my 37 week doctor's appointment today and my doctor told me my breasts are engorged. As uneducated as I am about the topic, I thought maybe that would be a good thing and mean I will definitely be able to produce enough milk for the baby. When I mentioned such, my doctor shook his head and said that I should be prepared to have to feed formula because there's a good chance I won't be able to breastfeed. I am completely devastated! He told me to wear good support bras and take Tylenol, and there might be a chance I could still breastfeed. At this time, there is no inflammation. Has anyone else experienced this? If so did you get any other suggestions offered to you?

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So What Happened?

Our little girl was born 5/15/07 by c-section and everything went well. It took four days for my milk to come in, but it has come in like a freight train! Olivia is breast feeding like a pro every two hours and I still have to pump in between feedings because I am so full. Thanks for everyone's encouragement and support!

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B.M.

answers from St. Louis on

I agree that you should call La Leche League. They are very helpful, and they give you advice that will get you established breastfeeding and help keep you breastfeeding for as long as you wish. The hospital/doctors are always quick to tell you to supplement with formula. Luckily, I ignored that type of of advice, and breastfed both sons for over a year.
I am confused, are you already producing milk while pregnant? If that's the case, then I don't see why you couldn't pump. A lot of women BF one baby while pregnant with the next (I did!) and it's not a problem, so I don't see why pumping while pregnant would be a problem. I'm wondering what could be going on that the Dr. would say engorgement will hinder breastfeeding. Makes no sense to me.
Kellymom.com is also a great site for any breastfeeding questions/issues. HTH!

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B.B.

answers from St. Louis on

Okay that is just bogus. I haven't experienced engorgement prior to giving birth, but I do not buy that you won't be able to nurse. Can you call the labor and delivery unit at the hospital where you will deliver and ask for the lactation consultant? You need a professional pro-breast feeder that can be by your side to help you get started incase a problem arises or incase you have a team of nurses and drs trying to talk you out of it. If you formula feed in the hospital (some hospitals talk moms into this claiming their baby isn't getting enough or saying mom can then get rest if they feed baby rather than you) - formula feeding starts the weaning process. Supply will meet demand and usually milk doesn't come in for a few days so if baby isn't sucking milk will not be encouraged to come.

I would treat engorement the same starting out as I would if I had just delivered and later became engorged. When you are cold it will be harder for letdown to occur. Engorgement makes it harder for a baby to latch on so you may need to message the breast in circular motions to help it out. Also a warm compress would be greatly beneficial as would a warm shower. Breasts are always less hard after warmth is applied. In case the hospital is not a breastfeeding friendly hospital or incase the nurses will not provide a warm compress, I recommend heading out to walmart or some other store that may carry those little packs that you can heat in the microwave for a couple of minutes and it stays warm for a couple of hours. They have gel based ones and rice based ones. They both would work just fine. I just cannot imagine a physician trying to tell you to give up on breastfeeding before you start. Perhaps he has seen other women with engorged breasts prior to delivery who were easily encouraged to stop nursing or not try, and thus thinks you can't possibly accomplish it either. I know my physician had that opinion of me with the natural birth idea. He almost snarled and practically told me I couldn't do it. After the delivery he bowed and said he wasn't worthy (as a joke of course) because he didn't expect me to pull it off so good. Be encouraged to try and you can succeed! Don't give up before starting and don't allow the dr to make you feel devistated. Take a deep breath and let that one go. Then figure out a way to make what you want to happen become a reality.

Are your breasts more painful than the typical pregnancy soreness? I realize this is your 1st so it may be hard to know, but are they increasingly painful as time goes by is maybe the better indicator?

Contact a lactation consultant/ le leche league leader from your hospital. If you took a breastfeeding class at your hospital contact the instructor. Many times the instructor and or other lactation consultants will be on call when your baby arrives so that if you have trouble you can call upon them to help you out. You will have to ask your nurses after delivery for the lactation consultant because often times they will try to help and may not be capable of doing the same job as the lactation consultant. I would however at least talk to a lactation consultant to put you fears at ease and to learn whatever you can about how that hospital operates with breastfeeding...are they pro, are there consultants on call to help after delivery, etc? All of that should be in place, but asking will only help you get your mind sorted as well as gives you time to figure out your game plan.

B. :)

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T.L.

answers from Peoria on

Hello S.,
Has your doctor given you any sort of explanation of why you will be unable to breastfeed? That does not make any sense to me. Have you discussed pumping/expressing your milk out and freezing it in 2 ounce increments as much as you can to help with the engorgement? I breastfed all three of my children. It will be good to have a supply on hand for those times when you want to get out of the house to go shopping or out to dinner. I had over 50 bags of milk in the freezer at one time when my daughter was born and it made it alot easier for me at times when I was unable to pump at work due to stress or for other times when I was sick. Also, pumping out the milk helps to keep your breasts working and flowing the milk for future use. The more you pump the more milk you are able to produce for your growing baby's needs. Just a suggestion though, the milk you have right now probably has the colostrum in it. That is the first parts of the milk that is especially good for the baby. You may want to mark those frozen bags so that you are able to feed those to the baby in the first weeks of the baby. The colostrum has certain antibioties that the baby uses for their immune systems.

I have to agree with this doctor regarding the good support bra! For the obvious reason, your breasts will end up saggy and out of shape! But also it will alleviate back pain, breast pain, and help you to sleep at night. I wore a bra to bed for the first year of breastfeeding. But that was me. I had trouble sleeping without one. And if you plan to do alot of outdoor activities then the support bra is quite helpful especially for those times when your breasts just more and more engorged.

The suggestion about the Tylenol bothers me. Most obgyn and pediatricians that I have had experience with has never suggested any meds until it was absolutely necessary. Most don't want breastfeeding mothers to take ANYTHING at all during breastfeeding because it can go directly to the baby in the milk. I've always been advised to either pump it out, for which I bought a hand pump for those very engorged times that the electric pump just couldn't get me started to release the milk.

And for those times where I was very engorged that I needed a quick release and the baby was just not ready to eat yet. I stored alot of milk this way. Also, after every feeding that the baby was done eating, I would continue to express the rest of the milk out that the baby did not drink and store for later needs. It made a very big difference in the end when I was no longer able to pump or when I was trying to wean my child off of breastfeeding and wanted to switch her over to a bottle of regular milk completely. I was able to just start puting the breastmilk in bottles half and half and then more and more until all of the breastmilk was gone and I was ready to switch.

I would suggest for you to get a second opinion or contact your local breastfeeding center for more information. They would be more helpful with your situation I am afraid than an obgyn who basically just brings the baby into the world. They would specialize in babies and feeding of babies. Try calling the baby's pediatrician and ask some questions as well.

Good luck and best wishes on your new motherhood! It is an adventure!
~T.

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N.T.

answers from St. Louis on

I have learned that it is actually more important to pump or feed when there is engorgement. But the fact that you are still pregnant, I am not sure. But here is a link you might want look at.

http://en.wikipedia.org/wiki/Breast_engorgement

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A.J.

answers from St. Louis on

S. S.

I can't imagine while your doctor would say something like you won't be able to breastfeed. I witnessed several other new mothers with several problems when my last babies were born. They were all able to work out engorgement problems, sore nipple problems, lack of milk supply, etc and ended up breastfeeding their babies for a year or more. Seek a lactation consultant, she will be more help than you could ever imagine. Sierra, at Kangaroo Kids on Manchester, will help you will all of your needs and questions. She knows everything and more about boobs! Just going there and getting some advice helped me exclusively breastfeed my twins for a whole year, when I had had reservations about it before then. ###-###-#### is the phone number.

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A.H.

answers from Springfield on

I've never heard of not being able to breastfeed when your breasts are engorged. My lactation consultant told me that if that were to happen there were a couple of things I could do. I could pump, hand express or see if my son was hungry. If I were you, I'd call the local hospital and ask for the lactation consultant. If there isn't one, Google the La Leche League. Seriously, I doubt very much that you'll not be able to breastfeed. Hope this helps!

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M.M.

answers from St. Louis on

S.,
I don't respond too often to the posts on Mamasource, but I just had to respond to this. Please don't be discouraged. This sounds ridiculous to me. Although I had not heard of being engorged before the baby is born, engorgement does not mean you cannot breastfeed. In fact, it is usually recommended that you do breasteed. I became severely engorged two days after my baby was born and got mastitis, and I continue to breastfeed my baby today, 5 months later. My OB prescribed an antibiotic that is safe for nursing mothers for the mastitis. And, the lactation consultant gave me tips to help relieve engorgement and help baby latch on until it resolved. I know you are just a short time until delivery, but if you have another baby, maybe get another OB more supportive of breastfeeding. In the meantime, I would ask your doctor to explain in more detail what you have and why he thinks you won't be able to breastfeed. Then, call a lactation consultant for a second opinion. I always worked with the lactation consultant at the hospital where I delivered my baby--she works with both inpatients & outpatients. HTH. Please don't give up!

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J.D.

answers from St. Louis on

I am also surprised about the advice your Dr. gave you. I agree with the other ladies that you need to get in touch with a Lactation Consultant. If you are delivering at one of the St. Louis hospitals like St. John's, Mo Bap, etc. they have a Lactation Staff.

After you deliver, request that a lactation consultant visit you every day during your stay. It is good to verify that you doing things correctly. Also, don't be afraid to call the lactation consultants at the hospital after you leave. I had some issues and they were always willing to talk to me and even have me come in as necessary.

Lastly, make sure you have a good pump whether you have a manual pump or electric. Even if you think you are going to exclusively breast feed it helps to take off some extra milk if you are engourged or some extra bottles to let your husband feed now and again through a bottle.

Three points of advice....

1. After 2 weeks of solid breastfeeding, purposely have someone else feed your baby a bottle of breast milk now and again. This will avoid the situation of you needing to be gone for a period of time and the baby won't take from a bottle.

2. When you are engourged, use your pump to give you some relief. It does take a few weeks for your levels to even out. However, the pump is great to take off some extra milk so that you don't feel so full. Plus, it helps to build a reserve for those bottles when you are not there to feed.

3. Some lactation consultants will insist on feeding every 2 hrs. When I went to St. John's they said every 3 hrs during the day and 4 hrs at night. Boy....did that make a huge difference because it gave me a little break between feedings and I found that I got a little more rest at night. Also, when those growth spurts came, I was feeding every 2 hrs not every 1 hr. It took me 3 kids to figure it out....so now I pass it on to everyone I know. What a difference in my breastfeeding experience when I went to the 3 hr/4hr rule!

Good luck to you.....if you really want to breastfeed, make sure you make yourself stick with it for 2 weeks. The first 2 weeks are hard.....you are tired and sore. However, if you can make yourself hold out for 2 weeks you will be really glad!

J.

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R.K.

answers from Detroit on

Oh my goodness, that is awful your doctor told you that you would be unable to breast feed. When my daughter was born 3 1/2 weeks early last spring I think I had enough milk to feed 5 kids with (due to engorgement) and my boobs were as hard as basketballs. While, it did take us awhile to learn to latch on and for my supply to level out, she is now over a year old and still nursing (now I wish I could stop, but we're moving soon and I figure I shouldn't stress her out more). Anyway, my advice to you...be prepared to work at it, nursing is not always easy, especially when you're engorged. Also, find a good support group and a lactation consultant. I had a support group I met with every monday and I knew I would get a good latch on there while working with the lactation consultant and I heard encouragement from women who were successfully breastfeeding and had been in my situation months before.

Nursing your baby is such an awesome experience both emotionally and nutritionally. Don't feel bad if you supplement here and there with formula right off the bat though, I did for a day or 2 when I first brought her home and it didn't alter my breastfeeding experience at all (except give my sore nipples a bit of a break which was needed).

I hope everything works out well for you!

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K.K.

answers from St. Louis on

Hi S., I, too, think your doctor is misinformed and I feel upset that he told you this. I wonder how much money he takes from the formula companies (but that's another subject). I have never heard of such a thing. I nursed my baby for 33 months and am active in our local Breastfeeding Mom's group - supporting mom's who nurse. Please check in to lactation consultant's in your community - the nursery at your hospital might have one on staff you could ask for reassurance, otherwise, they will be able to put you in contact. I think you need to speak to a professional who knows what they are talking about in order to relieve your stress. He's setting you up for failure and that is VERY unprofessional. Do you have a La Leche League? Check on line if you are not sure.

From on line: I wish I could find something better to quote you because this is so normal and so close to the baby being born. Hang in there momma! you're going to do great!!
email me if you can't find help and I'll put you in touch with my lactation consultant - [email protected]____.com

When will I start to produce breast milk and when will I know?

HeidiM: Hi, congrats! Late in pregnancy your breasts will start to produce colostrum, which is a nutrient-packed premilk. It's very hard to extract unless you're a newborn baby (and you shouldn't try, either! Though some women will start leaking a tad in the third trimester —especially if you've breastfed before — it's a good sign that all systems are go.). When your milk comes in, which is generally about three days after delivery, you'll know it! At that point your baby will be hungry for milk (they're not born hungry, and will only get the few teaspoons of colostrum they need in the first couple of days), and will drink up accordingly. Pretty soon, you'll get a good system of supply and demand started, and you and your baby will be a great feeding team! Good luck!

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K.S.

answers from Columbia on

i am no doctor, but I don't see why you will not be able to breastfeed. I was never engorged before the baby, but was really engorged afterwards. Did your Dr say to pump now? Maybe you could do that.
I would contact La Leche--they have great internet questions set up, or visit your lactation consultant. I know Kilgors in Columbia has a great one.
Good luck and I hope you can breastfeed. My son and I are still going strong!

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J.H.

answers from St. Louis on

I've never heard of such a thing, I even took a breastfeeding class before my son was born and never heard a thing about it. I'd check with someone skilled in the area of breastfeeding if I were you. Perhaps if you don;t produce enough milk to nurish your baby you could still do but suppliment with formula. I hope for you and the sake of your baby that you do at least try.

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G.N.

answers from St. Louis on

I never had or heard of that being engorged while pregnant, I was told your milk doesnt started coming in until after the baby is born. In the beginning its called colostrum then the hind milk its the thicker milk, I wouldnt get all worried now, you should have no problem with breastfeeding. A week after I delivered my son I got mastitis which was very painful, I had flu like symptoms and I was still able to nurse. I would do some research to get better educated on breastfeeding.

here is something i found you could readhttp://www.007b.com/wonders_breastmilk.php

If you have anymore problems or questions actually go to cafemom.com its a great group you can join and there is a group within that group breastfeeding or breast is best, great groups

HOpe that helps
G.
You can always send me a PM or email me at [email protected]____.com if you have any more questions or concerns

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J.W.

answers from St. Louis on

S.,

I'm not trying to put down your doctor, but he must be totally ingnorant in the breast feeding area! My advise to you would be to contact your local La Leche League leader and seek her advise. Also if you haven't already start going to the meetings now, you'll learn so much and have all your questions answered. Also you might look into going to a breast feeding class at your hospital where you plan to deliver. Below is a link to help you loacate your local LLL leader. Don't worry, I'm sure you will be able to breast feed just fine!! Take care and good luck to you and your new little one.

http://www.llli.org/Web/Missouri.html

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M.F.

answers from Springfield on

I always had milk or colostrum before I delivered my children and never had a problem breastfeeding them. I would just keep an eye on them...lol...and take tylenol if it inflames. You may want to ask your Dr. why he would think you wouldn't be able to breastfeed. I am wondering if he thinks it will dry up before you deliver??? Which wouldnt make sense either. Don't let them scare you, our bodies tend to take over and do the right things at the right time! Keep your chin up and congratulations on your baby!

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E.W.

answers from St. Louis on

I didn't experience this exactly, but I have a few ideas. I produced a LOT of milk (after my son was born). And I mean a lot- like I could pump about 10 ounces after my son ate his fill. If I didn't feed him first, I could pump about 20 ounces!!!! Well, have you tried just pumping right now? It will relieve the engorgement and still keep you producing milk. I think that's probably what your doctor is worried about- you losing milk production. You might have to keep pumping, but breastfeeding is totally worth it! Good luck!

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