We started my son, Corban, on homemade formula almost two months ago. Since then I have found quite a bit of relief from the stress of being the only one capable of feeding him. Nevertheless, I have not stopped nursing him. It was important to me to continue doing this and only supplement with the formula. As it turns out, my glutton of a son requires much more milk than I can produce, so we are actually supplementing his formula intake with breast milk.
In changing up how we feed him I have discovered that I have new hurdles to overcome. Not only are the feeding sessions shorter, they are less frequent. I went from having a baby attached to me every hour for 30-45 minutes to maybe every three hours (sometimes longer) for about 15-20 minutes. Even after all the reading I did while I was pregnant and the mental preparation I made to expect the different ways my body could react to such a change I still chose the lazy way out and kept saying, “It’ll be fine. I don’t need to change anything I am doing. I don’t feel any different.” Let’s just say I certainly felt different yesterday.
My husband and I have been vacationing with his father and stepmother. Although we are not far from home we decided to stay in a hotel room to simply get away as much as possible. Between other people feeding him, playing with him, and my reluctance to feed him like I usually do (at home there is practically no sense of modesty) we missed out on a lot of breastfeeding time. On top of all of this I didn’t bring a breast pump (I have never used one regularly) and I just started wearing a regular bra again this past week. Needless to say, at around 4PM yesterday I started feeling the weight of my decisions–literally.
I thought it was just where I was having to adjust to having an underwire again. Then I thought it may have been that the strap was too tight on my bra. I stepped away to changed clothes and it soon became apparent what the problem was–breast engorgement. I quickly grabbed Corban and we headed off to have some bonding time. I wanted to take care of it as soon as possible to avoid any potential problems.
Engorged breasts are very hard, and may be quite tender or painful. Swelling inside the breasts can even cause the nipple and areola to flatten out making the tissue difficult for the baby to latch on. The skin on your breasts may also appear to be taut and shiny and feel warm to the touch. How does breast engorgement affect breastfeeding you ask? Not only can engorgement cause the loss of some or even all of your milk supply, it can also cause nipple damage if breast milk is not removed. Breast engorgement can even lead to mastitis if too much milk remains in your breasts.
The causes of breast engorgement include:
- Missed, infrequent, or rushed feedings.
- Inadequate milk removal from breasts when feeding or pumping.
- Wearing bras that place pressure on the breasts.
- Making more milk than breasts can hold.
- Inadequate milk let-down due to swelling and/or pain.
- Stopping breastfeeding without slowly weaning the baby off of the breast.
To relieve engorgement you need to increase the flow of milk from your breasts with more frequent feedings. The goal is to decrease the swelling and enable baby to latch on effectively. Suggestions for preventing/treating breast engorgement include:
- Nursing frequently. Try to nurse at least 10-12 times in 24 hours – every 1 ½ – 2 hours during the day, with no more than a 3 hour stretch at night. Try to nurse for at least 15 minutes on the first side before offering the second. Don’t set time limits on time spent at the breast.
- Nursing baby with only a diaper on (skin-to-skin contact will stimulate sucking).
- Varying nursing positions using cross-cradle, football, or side-lying positions to help promote drainage of the breast.
- Wearing breast shells (with holes for air circulation) for 20 minutes between feedings.
- Wearing a supportive bra (avoid under-wire), but don’t bind your breasts – this can lead to plugged ducts.
- Lying flat on your back between feedings so that your breasts are elevated.
- Applying cold compresses to your breasts and under your arms between feedings. Cold can help reduce swelling. Use a layer of fabric between the compress and the skin. Bags of frozen vegetables or a disposable diaper that you dampen and put in the freezer for 20 minutes work just as well as the ice packs that you purchase at the drugstore. Apply cold compresses for 15-20 minutes off and on for 1-2 hours.
- Using heat immediately before nursing to help the milk let-down. Taking a warm shower, leaning over a basin of warm water, soaking in a warm bath, or applying warm compresses or a heating pad may help. Moist heat is best. Gentle breast massage can also help the milk flow more readily.
- If the nipple and areola are swollen, don’t try to nurse without softening them up first. Hand express or pump a little milk from your breast to soften the nipple and areola before trying to nurse. Gently massage the breast before nursing. If you use an electric pump, set it on MINIMUM and gradually increase the pressure after the milk begins to flow. You may not be able to turn it up to maximum, but try to increase the pressure as much as you comfortably can. Most pumps work better on the higher settings, but if the breast and nipple tissue is extremely tender, don’t try to increase the suction. Apply a few drops of olive oil to your nipple and areola before pumping to help prevent friction while pumping.
- Being careful about the type of pump you use. Many of the small inexpensive electric pumps can damage your tissue, since engorged breasts bruise easily due to increased blood volume. If you don’t have access to a high quality pump which cycles automatically, you may want to stick with manual expression. Even with manual expression or massage, be very, very gentle.
- Using cabbage leaf compresses. This sounds really strange, but this is a remedy that has been used for over a hundred years with much success. No one is exactly sure why it works, but since it is inexpensive, safe, and effective, you may want to give it a try. Here’s what to do:
- Buy plain green cabbage.
- Rinse and dry leaves. Put them in the refrigerator.
- Remove base of hard core vein and gently pound leaves.
- Wrap around breast and areola, leaving the nipple exposed. The leaves fit nicely around the breast, and the cold feels good.
- Cover entire breast, and if needed, the area under your arms.
- Change every 30 minutes or sooner if they become wilted.
- Check your breasts often and as soon as you feel the milk beginning to drip, or if your breasts feel ‘different’, remove leaves and try to nurse or pump.
- Re-apply as needed (up to 3 times between feedings). Check OFTEN, as over use can cause a decrease in your milk supply.
- Drinking a cup of sage tea (available at health food stores) at bedtime for a night or two may help in cases of severe engorgement. Sage is a powerful herb that contains a natural form of estrogen and may decrease your milk supply. As with cabbage leaves, monitor breast changes often as over use can decrease your supply.
Call your doctor if your temperature rises over 101, or if you develop localized pain or flu like symptoms. Even if you develop a breast infection, breastfeeding can and should continue. Breast engorgement is usually short-lived and typically subsides within 24-48 hours, but symptoms of breast engorgement can last up to 10 days.
I consider myself lucky in that I was able to very quickly address the situation. It is more than a day later and things feel and look fine. I just have to keep in mind that just because my life has gotten slightly more easy to manage because of the homemade formula I cannot shirk my responsibilities. I have an obligation to my son and to self-care.