Gender medicine: what is breast engorgement?

By Cristiano Antonino On May 22, 2023

Breast engorgement is a condition that affects mothers struggling with breastfeeding, especially in the first few months after giving birth

This condition, which is very common among new mothers, is usually temporary and can be treated quickly and easily.

Breast engorgement leads to a number of discomforts, including a significant sense of swelling, caused by increased blood flow and the presence of lymphatic fluid in quantities greater than physiological levels.

The pain, discomfort and other symptoms affect the mother and affect her ability to provide the baby with the nourishment necessary for its development.

The symptoms of breast engorgement are so debilitating that they can lead to the interruption of breastfeeding

Pain and swelling of the breasts are among the most common.

The discomfort and discomfort caused by this condition can lead to people wanting to stop breastfeeding and opting for artificial solutions for their newborn.

The complications of breast engorgement can be many, more or less serious, and the main one is mastitis.

This term refers to an inflammation due to milk stagnation that favours bacterial proliferation and can create severe discomfort and lead to fever and rhagades in the breast.

The condition may affect the mother’s ability to breastfeed as she may need to take antibiotics and, therefore, stop breastfeeding.

There are many remedies for breast engorgement, but before starting treatment it is necessary to establish a definite diagnosis and investigate the causes of the condition.

Symptoms

The symptoms of engorged breasts can be diverse and are very common among breast-feeding women.

In addition, these symptoms can occur in one breast or both, causing different discomfort and pain:

the most common symptom is swelling of the breasts, which are tense,
the breast may be hardened and become very sensitive to the touch, creating severe discomfort,
the skin of the breasts may be very tight and shiny or reddened,
the nipples may be hard and flat,
fever may appear even above 38 degrees.

Of course, one consequence of breast engorgement is difficulty in breastfeeding.

In fact, the change in udder consistency and nipple structure may lead to discomfort for the mother and discomfort for the baby, who may have difficulty latching on for suckling.

The baby’s difficulty in latching on to the breast may lead to reduced emptying of the breast, worsening the condition.

The causes of breast engorgement can be several

One of the most frequent is the baby’s difficulty in latching on to the breast: a baby who does not feed as often as necessary prevents physiological emptying of the breast.

Normally, a newborn baby must latch on at least eight times within a 24-hour period, approximately every three hours.

This frequency is subjective and can vary from baby to baby, certainly there must be a minimum number of times to allow the baby to grow during the first months, the most important for its development.

Furthermore, among the causes of breast engorgement, there may be previous breast surgery, such as breast augmentation, that may favour the onset of this condition.

While breastfeeding, it is essential to wear comfortable clothing made of soft materials.

One of the causes of breast engorgement is the wearing of inappropriate clothing, such as an unsuitable and very tight bra.

This garment can lead to blockage of the milk ducts.

A consequence of this condition can be mastitis.

A cause of breast engorgement can be the hormonal change due to childbirth, which causes several physical changes

In fact, the hormonal increase leads to an increase in the production of milk, which can be produced in greater quantities than the baby needs.

For this reason, breast engorgement can also affect women who do not breastfeed but who, for some reason, are subject to an alteration in their hormonal asset.

Finally, it is very common to suffer from the symptoms of engorged breasts when the baby starts weaning.

The intake of solid foods and the reduced need for milk required by the infant cause excessive milk production, which can be the cause of breast engorgement.

Differences with mastitis and breast engorgement

Mammary engorgement and mastitis are often confused, as is mammary turgor.

These three conditions may seem similar but have some fundamental differences.

Mammary turgor presents similar symptoms to engorgement such as swollen, sore and heavy breasts.

This condition occurs a few days after childbirth.

However, the difference between engorgement and mammary turgor is that the latter involves, in most cases, both breasts, does not lead to fever or hardening of the nipples, and milk can flow out easily.

The difference between breast engorgement and mastitis is crucial.

The latter is often a complication of engorgement and, for this reason, presents accentuated symptoms.

In fact, mastitis is characterised by severe pain that may be accompanied by very reddened and hot skin, and discomfort may affect only one breast or both.

In addition, in more complex cases, the patient may present a very high fever, muscle pain and a general feeling of malaise.

Breast-feeding when suffering from mastitis can be very painful, although it is recommended to empty the breast.

In some cases, to resolve mastitis, it is necessary to take proper antibiotic therapy, which can be prescribed by your general practitioner or gynaecologist.

How to prevent engorged breasts?

Mammary engorgement can be prevented through a few simple steps that can decrease the amount of milk in the breasts.

Ways to prevent engorged breasts include

frequent breastfeeding, which can remove milk residue and avoid stagnation,
relaxing and breastfeeding in quiet places,
before giving the baby one breast completely empty the other,
make sure the baby is in the correct breastfeeding position,
massage the breast, especially the areola and nipple,
avoid using bras with uncomfortable materials or in tight sizes.

How to relieve symptoms

The remedies for breast engorgement are many and can change depending on the degree of severity.

When the symptoms described above occur, it is necessary to

seek medical advice, following which analgesics such as paracetamol are sometimes prescribed,
breastfeed often, so as to clear the engorgement; if the baby does not latch on to the breast, a breast pump can be used,
make sure to empty one breast well before preparing the other for breastfeeding,
warm compresses before feedings and cold compresses afterwards, this can encourage the release of milk and subsequently reduce engorgement.

The ‘reverse pressure’ and ‘bottle’ method

Many women prefer manual remedies to resolve breast engorgement, which can unblock the engorgement without the use of breast pumps.

There are several ways to perform a proper breast emptying, among the best known are:

bottle method, which involves using a well-washed, wide-necked bottle. It is necessary to prepare the bottle by filling it with hot water, then it is necessary to empty it by filling it with boiling water. Finally, only the neck needs to be cooled, which is then placed against the areola to create a vacuum effect. This can lead to the spontaneous outflow of milk, functioning like a mechanical breast pump. The bottle method has been used for many decades by mothers around the world and its effectiveness is quite good. Nevertheless, it is crucial to be careful when heating the bottle with boiling water, because you can risk breaking the glass. For this reason, it is important to heat the bottle beforehand with lukewarm, not boiling water.
Reverse pressure is a natural method for treating breast engorgement. Before breastfeeding, the mother should lie down and massage the breast, especially using her fingers to apply constant pressure to the nipple. This softens the breast and the baby will find it easier to latch on to the breast.

This method was devised by US lactation expert K. Jean Cotterman. Through this gentle pressure of the fingertips on the nipple and areola, exerted by the rotary motion of the fingers, it is possible to make the breasts softer and resolve breast engorgement. The reverse pressure method is certainly one of the quickest and most widely used, due to its simplicity and effectiveness.

In any case, the advice is to consult your doctor, gynaecologist or breastfeeding expert.

During the preparatory courses, moreover, a great deal of useful information can be provided on breastfeeding and the pathologies that can affect the breast in the first months of the baby’s life.

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