When your milk comes in the chances are you will know about it – and it may come as quite a shock. There you are calmly enjoying (or surviving at least) colostrum feeding then whoosh…the colostrum calm is well and truly over and a rapid and quite alarming breast inflation takes place.
With my first child I was a mere passenger to the experience..watching with terrified fascination as my breasts, like the giant peach, grew bigger and bigger reaching and surpassing the limits of believability to become uncontrollable balls of pain.
I am a large producer of milk and first time was clueless as to the implications of that and how to manage this process of milk arrival. The result was engorgement so severe I was a whisker away from mastitis. Excellent postnatal care saved me with a well-timed visit from my midwife who took one look at the hot spots on my breasts and leapt into action. Her electric pump was immediately deployed and as the first few gallons of milk came off the relief was instant. I then had to follow a regime for a few days whereby I expressed surplus milk until the amounts pouring out puttered down from a tsunami to a trickle.
This time the fear was real…I did not want to get to that place again. Being a much more savvy breastfeeder this time round meant that while engorgement happened we were able to keep on top of it with the following techniques, or as I like to call it: The Engorgement Management Plan (EMP for short, entirely made up by me, please consult the disclaimer in the first edition regarding ANYTHING I say!). So here’s the EMP that worked for me:
1. Obsess: this may not be entirely healthy, um…I suppose a more useful suggestion would be vigilance. Monitor the hardnes, feed regularly and make sure the breasts are drained or at least soft(er) after a feed. Prod and feel and be aware! To make sure your baby drains your breast you may need to wake them up mid/post feed and reattach. We instigated a routine of a nappy change mid-feed, along with feet tickling, chin tickling and breast compression of hard bits if necessary when the baby was sucking.
2. Learn to Hand Express: Expressing milk is the last thing you actually want to do during this stage of breastfeeding as it will stimulate the breasts to produce yet MORE milk. The exceptions to this in normal circumstances are if you a) want to add in an extra expressed feed for future use as part of your routine or b) are in a state of breast crisis and expressing will save you from mastitis (see above) or some other nasty.
BUT hand expression has its uses – firstly it’s a lot more controllable than using an electric pump so you can take off just enough without stimulating the breasts too much to make more milk. This comes into its own after a feed if the baby has only fed from one side and you think the other may explode before the next feed…in this scenario, just take enough milk off the non-fed side to relieve and don’t be tempted to overdo it. The other time it has a place is before a feed if your breasts and, specifically the areas around the nipple, are so hard that latching on is impossible. In this case express a little bit off to just soften the latching zone (technical term!) enough to get a feed going.
As a side note, I think I should point out how much I detest hand expressing. For some reason the thought of it and doing it really makes me cringe BUT it is a breast saver and useful throughout the breastfeeding timeline, so learning how to do it isn’t a bad idea. There are loads of websites and videos online that teach it – I can’t decide which one to link to, so I would suggest Googling it and finding one that makes sense to you.
3. Think Biscuits: a useful bit of advice for every stage of pregnancy and child rearing BUT I’m suggesting you think biscuits in terms of the latch. When your breasts are in this place of hardness the baby may need some help latching on. Once you’ve softened the area enough (if necessary) shape the latching zone for the baby’s mouth. I have to ‘think biscuit’ when I’m doing this as I get so confused looking down at the angle of my baby in relation to my breast. This may just be me but I’ve started so I’ll finish…you eat a biscuit flat, so shape your nipple and surrounding area accordingly – as though the baby is taking a bite out of your biscuit breast… Don’t try to make them latch on to a wheel shaped biscuit. Does that make any sense at all!? DON’T FEED YOUR BABY BISCUITS. Ok, I sense I’m losing the plot a bit so I’ve tried to illustrate with photography (not my strength). You could just watch this video on latch, I don’t think they mention biscuits…
4. Avoid Heat: Well avoid heat unless you want to relieve your breasts of milk (see below). Roll the covers down under your chest for a few nights, don’t over-layer when dressing and avoid a direct blast from the shower or submersion in a hot bath
5. Use Heat: hot flannels, a hot bath, the shower…all will stimulate the flow and make it easier to leak or express milk if required..
6. Use Cold: Ahhh the relief from cold compresses -I tried cold flannels, cold cabbage leaves, ice gel pack things. All of these can help with the pain but, to avoid masking a solvable problem, we used them only alongside the action points in my EMP…and so we’re full circle at point 1: OBSESS!
You may now be wondering what happens to all the excess milk with all this leaking and hand expression…? Tune in next time for how I’m dealing with a large milk supply.
I know, what a cliffhanger that is!