Horrible engorgement - How much pumping is okay?

[Juise]

DD2 is working on day 4 here. My milk came in night before last and everything was okay. In fact, I had been very excited about how well nursing was going this time around, she learned to latch well right away, my milk came in and didn't flood the bed, it didn't even hardly hurt, just a little sore like I'd always heard it was supposed to be.

Then last night that was over.. totally engorged, dripping / spraying everywhere, slept soaking wet in milk all night, and could not, for the life of me, get baby to latch on. Over, and over, and over, I tried expressing some to soften things up for her to latch, didn't seem to help, I tried putting my rice pack on to warm and soften, and that didn't help either. Now she just tried for a second to latch, immediately get frustrated and angry and starts crying. I Just tried repeatedly for 2 hours to get her latched on to no avail, but she gets angry and cries when we *stop* trying, too, and roots like crazy!

My breasts are rock hard, and lumpy with ducts and I swear no amount of pumping seems to soften them up. Not to mention they hurt. I just pumped 6 oz off of one side after her trying to nurse off of it for 2 hours. How are you supposed to make sure they get emptied when there is that much?

How much can I pump to relieve pain or to try making things manageable for baby? I tried not to too much, but it hurts so bad. I'm so afraid I am only making it worse for myself, though. How do you decide what is too much? How do you know how long you can let it go and deal with the pain before you are in danger of getting mastitis? I had mastitis really bad with my first and ended up in ER twice for it, I am terrified of getting it again.

So baby is hungry, frustrated and angry, and I am tired, frustrated and getting really, really depressed. And my boobs hurt! Any advice?

[PatioGardener]

have you tried reverse pressure softening?

http://www.kellymom.com/bf/concerns/...cotterman.html

scroll down for pics.

and congrats!!!

[annettemarie]

I'm going to actually move this out to the main Breastfeeding forum, where lots of our new mamas hang out and can give you some "been there, done that" advice.

[terra-pip]

my third babe is 10 days old and what you described sounds just like what I just went through...minus the pumping. Now I could be wrong here but I always heard that pumping in the early days and while engorged could actually worsen the engorgement. What helped me this time and with my other two children was to get in a warm shower...lean over and just massage and express and get the milk out to soften the breast...usually babies get frustrated when they can't latch onto a too hard nipple and areola or the milk is coming so fast that they can't keep up...the shower trick always helped me. It gets the milk flowing gently and you can get a bit out without over stimulating like with a pump. And I just keep a lot of cloth dipes/burpie wipes or receiving blankets in bed with me in the early days...let the milk drip while they're nursing or while you're sleeping. Seems to me the pump would only hurt if you're that engorged.

Also might try some gas remedy for the babe in case her crying and air gulping is causing pain...especially if she starts crying as soon as she's in a nursing position or she's kicking her leg or arching her back.

hang in there mamma!!

[Juise]

Okay, so I tried the reverse pressure softening after applying heat, and it worked a little bit. I managed to get her latched and start nursing, but only for a moment and the swelling was back and she was squeaking and slipping again and couldn't get suction. It did mean though that I managed to get her fed by doing it repeatedly, bt not as much as either of us would like because she got fed up with the process pretty quickly.

Even keeping the hold on for a long time though doesn't create any sort of divot or dimple as they describe though.. it seems pretty straight forward, but could I be doing it wrong?

I'm fairly certain the frustration and crying is coming purely from not being able to nurse, she hasn't been seeming to have any gas issues or complaints or discomforts aside from trying to nurse, and even then she is amazingly patient before getting upset.

I just tried a warm shower, I couldn't get anything to come out before doing the RPS thing, but doing that, then expressing and massaging and repeat got me some level of comfort. Unfortunately (of course) now I can't get her to rouse at all to take advantage of the softening, and it is already going away and getting back to quite painful. (I'm sitting here in my towel ) It also took a long time to get any degree of softening from it, I ran the hot water out, and there are only so many showers you can take in a day, you know? Especially with a toddler and a newborn,

So.. I am happy we got somewhere at least, but, er, are there any other thoughts? What about applying ice? I've heard that may help, but I think it is only to help manage the pain, not the oversupply, is this true? If it is only for the pain I have about 0 desire to put ice on my boobs but if it will help with the oversupply I'd do it.

[terra-pip]

Did your baby latch on well before the engorgement? And does she get a good feeding sometimes? I ask because if theres something not quite right about her latch it could be setting up a cycle of her not latching well and you getting engorged and her unable to latch well...

If she's getting something and putting out the dipes to prove it i would just keep working on your engorgement...just keep doing what you can and hopefully it will go down in the next few days. Engorgement usually peaks and then subsides with some lingering in the middle of the night and mornings sometime by thesecond week or so. I have a sleepy nurser as well...I have to put her on the breast for my comfort as well as her demands because she will sleep the day away...and sometimes fall asleep while nursing too soon...so I just unwrap and tickle her cheek or feet or sit her up on my shoulder until I can get her interested again. And try not to go more than 4-5 hours at night...it's nice that mine will sleep longer but at this point it just makes the breasts hard and uncomfortable.

Have you tried cold cabbage leaves in your bra? might help.

[frogautumn]

I agree with Terra-Pip--have you considered calling a LC just to make sure your LO's latch and positioning are *perfect*? It can help a great deal! It was the best thing I ever could have done with DS#1.

Also, are you and your older child open to nursing? They are awesome at reducing the pressure and giving you a little comfort. This was a lifesaver for me when DS#2 was born!!

Congrats on your new little one! Hang in there, I know what those first days are like!

[PatioGardener]

http://www.kellymom.com/bf/concerns/...gorgement.html

nak hope this may be useful

[MeepyCat]

My suggestions for this are all pretty focused on the practical end of things, but in your situation, I would REALLY not pump. It'll make things worse.

With this kind of milk supply, you can't make sure the breast is empty. The best you can do is try to manage things to prevent foremilk/hindmilk imbalance, and to gradually reduce the overage. Reverse pressure softening helps. So does block feeding (feed for 2-4 hours on one side only, until that side is soft, then switch to the other side for 2-4 hours). I found hot compresses more helpful than ice for managing the discomfort.

In terms of waking up soaked, getting soaked, etcetera - mama, you just need to keep a stack of clean t-shirts someplace and do lots of laundry. Better, get someone to do it for you.

[Juise]

terra-pip - Yes, she had an excellent latch right away and took to nursing very nicely up until the engorgement I had managed to get her at least fed with the combination of trying to express some first, applying heat, and doing the RPS, but in order to get through a nursing session these steps had to be repeated over and over again because the swelling came back very quickly and she would lose her latch again. Unfortunately there is no "cycle" of engorgement, it hasn't actually left at any given point yet, including when she is done nursing. I haven't tried cold cabbage leaves yet, I will get my husband to pick some up tomorrow, can anyone tell me a bit more about this? I was hoping to just do what I could and get by this stage, but I think I may be getting / have mastitis in my right breast already But I am going to be opening another post to ask about that, so I will spare the details here.

frogautumn - I have a friend who is a LC and I am going to call her tomorrow, but I am pretty confident that the problem is entirely the engorgement, not our ability to have a good latch, especially since things were going so wonderfully before this happened. But who know, maybe she can suggest something else? I did talk to my midwife about it, and didn't really get anything from her that I didn't already get here.

As to DD1, she only stopped asking to nurse a couple weeks ago, and the little toad will have nothing to do with it! Which is something else entirely that I, at least, am feeling very sad about, though she doesn't seem bothered at all. I just get, "No, just the baby." I'm still hoping to renew our nursing relationship, I lost all of my milk during pregnancy and she hasn't actually nursed in quite some time now. She would just ask, latch, and pop off. I was so sure she'd be right back to being my little boob fiend as soon as my milk came in, and I am so sad that she now has *no* interest. But I don't have the energy to attack that issue quite yet, not until this one is over at least

PatioGardener - Thank you for the link, I had actually read that one over, it is a good one.

MeepyCat - I don't want to pump at all, I have still only used it 3 times now, I just finished the third session after realizing that my one breast is covered in red splotches and I got freaked out. I wasn't sure before because both breasts have been so swollen and hot feeling and painful to the touch, that I thought it was just the engorgement. Now that I have finished pumping though I can feel a lot of hard, painful lumps in this one, too. *sigh* But much of the problem is that without pumping I can't *get* to even remotely soft, not even when she finishes nursing.

In good news, as of this evening my left breast I think is still engorged, but no longer severely engorged. It is still uncomfortably full and tender to the touch, and still tries to choke and drown my daughter, but it is SO SO SO much easier to get her latched on and fed on that side!! Unfortunately, at the same time, she will no longer have *anything* to do with my right breast at all, not that I blame her, but it isn't making it easy not to pump, that's for sure. On that side now I can't manage to hand express anything no matter that effort I put into it, I can only get a very slow drip that doesn't help anything at all.

[terra-pip]

Go ahead and call your LC friend. And maybe go ahead and take some Motrin or Tylenol for the pain. Also when I started getting clogged milk ducts with my oldest...a tip my MW gave me helped. Try nursing for just a sec while kneeling over the babe on hands and knees on your bed...it sounds weird but the leaning over gets gravity working in your favor.(Why leaning over in the shower helps) And depending on the direction you lean you could get her chin working against the sore spots to get the milk moving. It's the clogging of a duct that sets the stage for mastitis. And if you can get someone to stay with you...I would say a day of bed rest and non stop nursing!

I know it's hard..my little ones always favored the breast that sdidn't drown them too!