Breast Engorgement

Who at risk??

•Delay in starting soon after birth
•Infrequent feeding
•Poor attachment
•Short durations of feeds
•Small breast
Robson (1990) – small breast (34%), normal sized breast (12.5%)
•Previous history of engorgement
70% of multiparous mothers experiencing engorgement also had engorgement with previous babies
Mc Lachlan et al (1991)
•Hyperlactation
•Less skin to skin contact
less engorgement on day 3- skin to skin care of their babies
Shiau (1997)

management

•rest
•Balanced nutrition
•Adequate amount of water
•Be calm
•Massage of the back
•Early frequent feeding
•Self demand feeding (at least 8-12 feeds /24 hours)
•Unlimited sucking times
•Correct suckling techniques
•No pacifier etc
-Section 3.2 Session Outlines Breastfeeding Promotion And Support In A Baby_Friendly Hospital, A 20 Hours Course For Maternity Staff (UNICEF, WHO)
- Core Curriculum For Lactation Consultant Practise (ILCA 2002, edited by Marsha Walker)

Alternate breast massage (while feeding the baby)

Other methods

Heat application
•Poorly researched
•Activate milk ejection reflex
Warmth application
•Shown to improve oxytocin uptake

Cold therapy
•Vasoconstriction –first 9-16 min
•Deep vasodilation: 4-6 min
Robson (1990), Sandberg (1998)