Engorgement

[@llli*feedingmama27]

Hi ladies...back for advice for.baby no. 3. I had a quick natural birth that went very well. My milk came in the next day. Despite a few latch issues at the first feed that caused some bobos she has been nursing every 3 hours the first 3 days of life but since yesterday I am super engorged. She nursed every 2 hours today but tonight is sleeping a long stretch. We tried stimulating her, taking off pj's, cold washcloth on hr feet but the girl is sleeping. Now I am trying to relieve the Engorgement with hot compress and extracting every once in a while. I am hesitating to pump it out after or in between feeding cause with the other babies I went in ovee supply and had to take sage to slow things down. Otherwise she is evidently feeding well...hasn't lost any weight since birtg maintaining. ..poops and pees a ton and you can see that she is gainin just by looking at her little arms and cheeks filling out. Should I pump or not? Or just wait it out...it will gwt better in a few days? Sorry for the long post. Thnaks in advance for any advice.

[@llli*maddieb]

Hi and congratulations on baby number 3!

I think in situations like this you have to take the situation hour by hour, and deal with whatever the most pressing issue is. In your case, it sounds like baby is nursing well and getting plenty to eat, but as your milk is coming in (production usually increases rapidly the entire first week) you and your more sleepy newborn are not quite in sync.

So baby is fine, so what you need to think about is your health. Some degree of fullness is entirely fine. But when the breasts are very full or engorged for any length of time, that puts you at immediate risk of pain, plugs and/or mastits. Engorgement can also make it harder for baby to get a good latch and may cause nursing issues in that case. So that (the engorgement) is the more pressing concern, more immediate than the risk of causing problematic OP.

So, here are the steps I would suggest. First, encourage baby to nurse frequently even if it means waking baby. Baby nursing will not cause OP nor will more frequent nursing or being awoken/encouraged to nurse harm baby in any way. If baby will not nurse or will not nurse enough, hand express enough milk from the breast(s) to feel comfortable. No need to "empty" the breast, you just want to get softer and comfortable. If hand expression is not doing the trick, then you can try pumping assuming you have a safe and effective pump. Pump at a gentle level and try not to pump too long. Again, you want to just get to a point of some softness and comfort, NOT "empty" the breasts. Emptying the breasts is a technique for increasing milk production.

Engorgement consist of both too much milk in the breasts and swelling in the breasts from both excess water (edema) or swelling from inflammation. Any possible edema caused by IVs in the hospital will resolve itself over the next several days without you doing anything else. For swelling or pain from inflammation, cold compresses are probably going to be more effective than hot. Hot compresses on the breasts increase inflammation and are no longer usually recommended for engorgement. Some moms find they need heat to get a nice letdown of milk. In that case, try hot compresses on your back, neck or shoulders, or warm shower with the water going on your back rather than your front. If you find you need the hot compresses right on your breasts, use that for right before baby nurses and try cold for dealing with the inflammation.