What’s going on
Perhaps what’s even more remarkable than visible
changes is the extensive changes that are taking
place inside of your breasts. The developing
placenta stimulates the release of estrogen and
progesterone, which will in turn stimulate the
complex biological system that helps to make lactation
possible.

Before you get pregnant, a combination of supportive
tissue, milk glands, and fat make up the larger
portions of your breats. The fact is, your newly
swollen breasts have been preparing for your
pregnancy since you were in your mother’s womb!

When you were born, your main milk ducts had already
formed. Your mammary glands stayed quiet until
you reached puberty, when a flood of the female
hormone estrogen caused them to grow and also to
swell. During pregnancy, those glands will kick
into high gear.

Before your baby arrives, glandular tissue has
replaced a majority of the fat cells and accounts
for your bigger than before breasts. Each breast
may actually get as much as 1 1/2 pounds heavier
than before!

Nestled among the fatty cells and glandular tissue
is an intricate network of channels or canals known
as the milk ducts. The pregnancy hormones will
cause these ducts to increase in both number and
size, with the ducts branching off into smaller
canals near the chest wall known as ductules.

At the end of each duct is a cluster of smaller
sacs known as alveoli. The cluster of alveoli is
known as a lobule, while a cluster of lobule is
known as a lobe. Each breast will contain around
15 – 20 lobes, with one milk duct for every lobe.

The milk is produced inside of the alveoli, which
is surrounded by tiny muscles that squeeze the
glands and help to push the milk out into the
ductules. Those ductules will lead to a bigger
duct that widens into a milk pool directly below
the areola.

The milk pools will act as resevoirs that hold the
milk until your baby sucks it through the tiny
openings in your nipples.

Mother Nature is so smart that your milk duct
system will become fully developed around the time
of your second trimester, so you can properly
breast feed your baby even if he or she arrives
earlier than you are anticipating.

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The causes
Within 72 hours of giving birth, an abundance
of milk will come in or become available to your
baby. As this happens, more blood will flow
to your breasts and some of the surrounding tissue
will swell. The result is full, swollen, engorged
breasts.

Not every postpartum mom experienced true
engorgement. Some women’s breasts become only
slightly full, while others find their breasts
have become amazingly hard. Some women will hardly
notice the pain, as they are involved in other
things during the first few days.

Treating it
Keep in mind, engorgement is a positive sign
that you are producing milk to feed to your
baby. Until you produce the right amount:
1. Wear a supportive nursing bra, even
at night – making sure it isn’t too tight.
2. Breast feed often, every 2 – 3 hours
if you can. Try to get the first side of your
breasts as soft as possible. If your baby seems
satisfied with just one breast, you can offer
the other at the next feeding.
3. Avoid letting your baby latch on and
suck when the areola is very firm. To reduce
the possibility of nipple damage, you can use
a pump until your areola softens up.
4. Avoid pumping milk except when you
need to soften the areola or when your baby
is unable to latch on. Excessive pumping can
lead to the over production of milk and prolonged
engorgement.
5. To help soothe the pain and relieve
swelling, apply cold packs to your breasts for
a short amount of time after you nurse. Crushed
ice in a plastic bag will also work.
6. Look ahead. You’ll get past this
engorgement in no time and soon be able to
enjoy your breast feeding relationship with your
new baby.

Engorgement will pass very quickly. You can
expect it to diminish within 24 – 48 hours, as
nursing your baby will only help the problem. If
you aren’t breast feeding, it will normally
get worse before it gets better. Once the
engorgement has passed, your breasts will be
softer and still full of milk.

During this time, you can and should continue to
nurse. Unrelieved engorgement can cause a drop
in your production of milk, so it’s important
to breast feed right from the start. Keep an
eye for signs of hunger and feed him when he
needs to be fed.

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