What helps relieve severe engorgement?

[@llli*lolaminis]

My sister's DD is 4 days old, milk has just come in, and she is so totally engorged that even her sleep shirt causes discomfort. She has a golf-ball size lump under her arm. DD is managing to latch even though the nipple is quite reduced due to the engorgement. This is her 2nd so she isn't a stranger to BF but didn't go through this with her first, so she's wondering what she can do to get some relief?? She is not thinking it's mastitis. Any suggestions?? She did have to take a pain reliever already... cabbage leaves? Cold compresses? Anything??
THANKS a million!!

[@llli*phi]

Cold compresses worked very well for me. I kept a bowl of water in the fridge to soak a towel and get it nice and frigid. I've heard good things about cabbage leaves but never tried them because the cold compresses worked so well. I also needed to massage my breasts in the shower to loosen up plugs. Sorry she's dealing with this. It isn't fun.

[@llli*phi]

Also, she can express just enough milk (by hand preferably) to be comfortable if the pain gets too bad. Just make sure not to express to much because it will only make things worse. I had to do this on occasion when I just couldn't tolerate the pain.

[@llli*laurenc]

When I have engorgement it was awful, so I totally feel for your sister. I would try handexpressing when I was taking a hot shower, then afterwards, I would use a ice pack wrapped in a thin towel to hug while I tried to sleep. I also took docter prescribed Ibuprofen (800mg)... otherwise I was literally unable to function. Once the baby sucks away those knots, then she'll feel much better. Pumping didn't really help... in fact, it made things worse for me. The pump was unable to draw any milk out from my plugged ducts, so I eventually developed Mastitis.

Good Luck! Have her baby keep sucking and sucking and sucking!

[@llli*lllmeg]

Good Luck! Have her baby keep sucking and sucking and sucking!

Yes the single most important thing to do when engorged is to keep the milk flowing. Hopefully baby is nursing well, in which case baby should be brought to the breast very, very frequently. Think unlimited access. If baby cannot handle it all, your sister can hand express and/or pump-but only "to comfort," to the point she feels relief from the pressure. And I would suggest hand expression or even just getting in the shower and massaging the milk out over pumping. Pumping too much on top of nursing at this point could cause more issues, not only creating too muc supply but drawing fluid into the areola. Getting the milk out frequently on top of the comfort measures and measures to relieve the swelling suggested above should take care of things quickly.

Also just as an aside, for a long time heat was suggested, but since heat can cause more swelling, cold compresses may well work better. When a mom is engorged, its not only that she has too much milk, but the breasts actually can get congested.

If baby cannot latch well, she can try reverse pressure softening.

[@llli*lolaminis]

Wow, thank you so much everyone for the prompt and helpful replies.
Any guesses as to how long this may last??

[@llli*phi]

I think it varies a lot from person to person. It should clear up sooner rather than later if she can avoid pumping. I had problems for about 3 months (it started getting better around 8 weeks), but I went back to work very early and was pumping. I don't think it would have lasted nearly that long if I wasn't pumping. For some people it can get better in a matter of days or weeks.

[@llli*lllmeg]

It should go away pretty quickly if baby is nursing well and frequently-UNLESS your sister has oversupply aka overabundant milk production or there is something else preventing quick regulation of milk production to ‘normal’ levels-meaning levels appropriate for this baby. Really we could be talking anywhere from just hours to weeks, no way to know, it depends on why the engorgement is happening and also what is being done about it. Some moms never experience engorgement and others really struggle with it-and as with your sister, this can vary from baby to baby. Since your sister nursed before I think this is not likely the case here, but, just for folks information, very often engorgement is created or made worse by not allowing baby to nurse frequently enough or when a baby cannot latch and nurse well enough, nursing scheduling or delaying feeds, and unnecessary pumping or too much pumping in the early days.

BTW if she continues to have hard lumps that could mean plugged ducts. Much of the remedies are the same but here is some specific to plugs info: http://www.llli.org/docs/00000000000...plugsblebs.pdf vibration seems to help with plugs. this article also talks about blebs, which are plugs that appear on the nipple and require a slightly different approach to the within the breast plugs.

article on engorgement and reverse pressure softening: http://www.llli.org/faq/engorgement.html

[@llli*lolaminis]

Again, thanks a million everyone. She is very grateful for the responses! She already feels better after a hot shower and has the bowl of water chilling in the fridge. Hats off to all of you who have dealt with this!! I only had the occasional plugged duct and can only imagine the pain and discomfort you feel when engorged!!

[@llli*lolaminis]

And I forwarded her the links - thank you, lllmeg!!