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Too Much Milk
How to Avoid Engorgement
By Melissa Clark Vickers, IBCLC
In one sense, engorgement is part of a very normal process that prepares a new mother to breastfeed her infant. The breasts enlarge with mature milk and other fluids, typically within the first three to five days after birth. Up until this time, the breasts have colostrum, a highly-concentrated first milk. This "liquid gold" is perfect for the newborn's tiny stomach and digestive system as he learns to milk the breast effectively.
When he is ready to handle larger meals, the breasts are ready with more milk. Eventually, the breasts will settle into a pattern of making milk based on the infant's needs, as judged by how much he takes from them.
Clinical engorgement is a serious condition in which the breasts become so full that they feel like rocks. The swelling may extend well into the armpits and upward toward the neck. The breasts are typically hot to the touch and painful and interfere with a baby's nursing.
Remember that in order to effectively nurse the breast, Baby has to be able to compress the areola, the dark area surrounding the nipple. With true engorgement, Baby can't get onto the breast far enough to milk the sinuses below the areola. It is a little like trying to nurse a basketball!
Unfortunately, when that milk is not effectively removed, initially more milk will be added to these already distended breasts. If the condition isn't treated, the breasts will take this as a signal to cut back on milk production. Obviously, this is a condition to be avoided when possible and treated quickly if it does happen!
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