Breast Fullness

When the breasts become heavy and full, having the baby sucking the breasts to help the secretion of breastmilk will loosen the breast. Some mothers breastfeed the baby immediately after delivery and can breastfeed by their babies’ demand. They may not experience breast fullness but the babies still grows well. In 1 to 2 weeks of postpartum period, mothers will need to breastfeed by the babies’ demand or express breast milk regularly. When breastfeeding reaches a balance between supply and demand, the mothers won’t feel any breast fullness, which is a normal physiological condition and not due to a reduction in breast milk supply.

Breast Engorgement

Postpartum engorgement often happens between the 3^rd to the 8^th day after delivery. During this period, the production of breastmilk has begun to increase and so does the body fluid accumulation at the breast tissue, resulting in edema and pressure on the mammary glands. The breastmilk could not be discharged successfully and the mother would feel the breast being swelling and painful. The best way to prevent breast engorgement is to meet the baby’s demand early and breastfeed frequently.

Treatment for Breast Fullness and Breast Engorgement

1. Breastfeeding by baby’s demand, regardless of which feeding posture is chosen, follow the principles of “Loosen, Align, Face, Wide-Open, Attach, and Support.” Refer to Figure 1 for breastfeeding posture.

• Loosen: Relax and take the most comfortable pose.
• Align: The ears, shoulder and leg of the baby should be aligned in one straight line.
• Face: The mouth of the baby should face the breast of the mother.
• Wide-Open: Let the baby latch the breast after opening the mouth wide-open, so that the baby can latch both the nipple and the areola.
• Attach: The chin of the baby needs to attach to the breast of the mother while the body attached to the mother also.
• Support: Both the mother and baby need to have good support for the bodies. Use the pillow or throw pillow.

2. Make sure the baby is attached to the breasts correctly. Signs of correct sucking by baby (Figure 2).

• Mouth wide open, latched to the nipple and areola.
• Chin attached to the breast, the area of areola latched by the lower lip should be more by the upper lip, and the lower lip flips out.
• Plump cheeks when sucking the milk, slow and deep sucking motion (approximately one suck per second).
• Observe the swallowing motion or hear the swallowing sounds of the baby.

3. Mothers without breastfeeding should express the breast milk in every 2 to 3 hours (8 times or more/day).
4. Apply hot compress to the breasts before breastfeeding (the water temperature should not exceed 42℃). Gently massage the breasts shoulder and neck for relaxation to increase the oxytocin reflex (let-down reflex), which could help so the milk flow smoothly.
5. After breastfeeding, apply a cold towel or cabbage leaves to the breasts, in order to reduce the discomfort and pain. Doctors could prescribe medication for pain relief for the swollen breast. It is safe to breastfeed while taking oral analgesics.

Figure 1 Breastfeeding Posture	Figure 2 Signs of Correct Sucking by Baby